胸腰椎损伤手术治疗失误原因分析  

Analysis of Failed Primary Surgical Treatment of Thoracolumbar Fracture

作　　者：金大地[1] 瞿东滨[1] 陈建庭[1] 江建明[1] 王吉兴[1] 冯岚[1] 

机构地区：[1]第一军医大学南方医院骨科,全军脊柱外科中心,广州510515

出　　处：《中国矫形外科杂志》2003年第14期952-954,共3页Orthopedic Journal of China

摘　　要：目的 :分析胸腰椎损伤手术治疗失误的原因及对策。方法 :1997年 5月～ 2 0 0 1年 5月收治因手术失误而再次手术的 63例 ,通过临床检查结合影像学X线平片、CT或MRI检查 ,对初次手术失误的原因进行评估分析。结果 :63例初次手术失误原因 ,可分为二类 :( 1)手术方法选择失误 :包括前、后路术式选择不当 4例 ,椎管减压术应用不当 8例 ,内固定器械选择不当 5例 ;( 2 )手术技术应用不当 ,包括脊柱骨折复位不良 2 9例 ,椎管减压不彻底 2 8例 ,内固定技术不良 3 2例 ,术中可疑伤及脊髓 5例。结论 :对胸腰椎损伤手术治疗需正确选择术式及正确应用减压及内固定技术。Objective: To find out the cause of failed primary surgical treatment of thoracolumbar fractures.Method:Sixty-three cases of thoracolumbar fracture received secondary operation,reasons of failed primary surgical management were noted by physical examination,X-ray film,CT or MRI scanning.Results:The reasons accounted for failed primary surgical management in 63 cases of thoracolumbar fractures could be classified into two items:(1)mistake choose of operative methods,including incorrect spinal choose of anterior or posterior approaches in 4 cases,incorrect spinal canal decompression in 8 cases,and incorrect choose of spinal instrumentation in 5 cases;(2)incorrect use of spinal technique,including failed reduction of spinal fracture or dislocation in 29 cases,incomplete decompression of spinal canal in 28 cases,incorrect spinal instrumentation in 32 cases and suspected spinal cord injury in 5 cases.Conclusion:It is essential for spinal surgeons to choose correct surgical approaches,spinal canal decompression and spinal instrumentation techniques in order to minimize the failed primary surgical management of thoracolumbar fracture.

关 键 词：脊柱 胸腰椎损伤 手术治疗 

分 类 号：R687[医药卫生—骨科学]