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作 者:宋能良[1] 陈汝昌[1] 黄建民[1] 廖穗波[1]
出 处:《医学理论与实践》2003年第5期509-511,共3页The Journal of Medical Theory and Practice
摘 要:目的:探讨经前路减压,应用The Centaur/Plate System内固定治疗胸腰椎爆裂型骨折并截瘫的临床效果。方法:术前常见CT扫描,经胸膜外-腹膜后入路,对5例胸腰椎爆裂型骨折并截瘫患者进行前路彻底减压,取髂骨或/和肋骨行椎间植骨,应用The Centaur/Plate System进行复位、内固定术。结果:5例均获得8~10个月的随访,平均9个月,椎间植骨全部完全融合。融合时间为3~5个月,平均4个月。除1例患者Frankel分级达2级以上改善外,其余患者均获得行走功能,Frankel分级达E级。椎管狭窄面积术前平均为68.9%,术后椎管无狭窄。术前后凸成角15°~30°,平均20°,术后为0~6°。随访期间,无异常发现。结论:经前路减压直接彻底,为脊髓神经功能的恢复提供了最佳环境。The Centaur/Plate System为脊柱前路内固定系统。设计科学、合理,固定良好,能恢复脊柱的生理弯曲。工具使用简便,可靠。内固定材料为钛合金。生物相容性好,是治疗胸腰椎爆裂型骨折并截瘫的一种疗效可靠的方式。Objective:To study the clinical effect of treatment of thoracolumbar burst fracture complicated by paraplegia with anterior decompression and internal fixation of the centaur/plate system. Methods: After CT scanning, the anterior decompression was carried out on 5 cases of theracolumbar burst fracture complicated by paraplegia through extrapleural intraperitoneal approach. An illium and /or rib was removed to be used for intervertebral transplantation. The reduction and fixation of them were performed with the centaur/plate system.Results:5 cases had been followed up for 8 ~ 10 months (on the average 9 months) .The results showed that the bone tvansplanted intervertebrally was fused together completely. The fusion of bone lasted 3 ~ 5 months,on the average 4 months. All of patients had recovered their walking function and their Frankel grading reached E with exception of one case the walking function of whick had inproved to Frankel grading 2. Before operation the average area of strictured vertebral tuke was 68.9% and the angle of kyphosis was 15° ~ 30°,on the average 20°. After operation the area of vertebral tube became normal and the argle was 0 ~ 6°, and during the follow-up period they were not found abnormal. Conclusion: Anterior decompression is a dired and thorough therapy for thoracolumbar burst fracture complicated by paraplegia and may provide a condition for recovering the function of nerve of spinal cord. The centour/plate system is an anterior and internal fixation system of spinal column. It is designed very rationally It can fix the fractured bone very firmly and recover the physiologiedl curve of spinal column to normal.The material needed to make the structure is titanium alloy. Internal fixation with centaur/plate system is a effective way for treating thoracolumbar burst fracture complicated by paraplegia.
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