侧前方减压在胸腰段爆裂骨折中的应用

发布时间：2019-04-09 20:05

【摘要】：目的:评价侧前方减压手术治疗胸腰段爆裂骨折并伴神经损伤的效果。方法:收集从2013年8月-2015年3月我科20例胸腰椎爆裂骨折合并有神经损伤患者,行侧前方减压钛网植骨内固定手术治疗的临床资料。根据影像学检查资料,观察术前、术后3天、术后3个月、术后6个月及术后1年骨折椎体前缘高度压缩百分比,Cobb角,椎管占位率情况,脊髓神经损伤恢复情况按ASAI分级比较.结果:20例患者术后均得到随访,随访时间为3个月到1年,术前骨折椎体前缘高度压缩百分比为55.6%±14.8%,Cobb角为26.8°±3.2°,椎管占位率为37.8%±12.6%;术后3天骨折椎体前缘高度压缩百分比为96.2%±6.4%,Cobb角为5.4°±1.7°,椎管占位率为2.4%±3.6%;末次随访骨折椎体前缘高度压缩百分比为93.8%±6.8%,Cobb角为7.2°±2.1°,椎管占位率为2.6%±3.0%.通过统计学分析,术后和末次随访分别与术前比较各项指标有统计学意义(P0.05),与术前比较脊髓神经损伤恢复满意。结论:侧前方减压内固定治疗胸腰段爆裂骨折合并神经损伤,能够有效恢复骨折椎体高度,纠正脊柱后凸畸形,并且椎管减压彻底充分,内固定牢固,脊髓神经损伤恢复满意,是治疗胸腰段爆裂骨折伴神经损伤十分理想的手术方式。
[Abstract]:Objective: to evaluate the effect of lateral anterior decompression in the treatment of thoracolumbar burst fracture with nerve injury. Methods: from August 2013 to March 2015, the clinical data of 20 patients with thoracolumbar burst fracture complicated with nerve injury were collected and treated with lateral anterior decompression titanium mesh internal fixation. According to imaging data, the percentage of anterior vertebral compression, Cobb angle and space occupying rate of vertebral canal were observed before, 3 days, 3 months, 6 months and 1 year after operation. The recovery of spinal cord nerve injury was compared according to ASAI grade. Results: all patients were followed up for 3 months to 1 year. The percentage of anterior vertebral height compression was 55.6% 卤14.8%, the Cobb angle was 26.8 掳卤3.2掳, and the space occupying rate of vertebral canal was 37.8% 卤12.6%. The percentage of anterior vertebral compression, Cobb angle and spinal space occupying rate were 96.2% 卤6.4%, 5.4 掳卤1.7 掳and 2.4% 卤3.6%, respectively. In the last follow-up, the percentage of anterior vertebral compression was 93.8% 卤6.8%, the Cobb angle was 7.2 掳卤2.1 掳, and the space occupying rate of vertebral canal was 2.6% 卤3.0%. By statistical analysis, the postoperative and final follow-up were statistically significant (P0.05), and the recovery of spinal cord nerve injury was satisfactory compared with pre-operation (P0.05). Conclusion: anterior lateral decompression and internal fixation for thoracolumbar burst fracture combined with nerve injury can effectively restore the height of fracture vertebral body, correct kyphosis deformity, complete decompression of spinal canal, firm internal fixation and satisfactory recovery of spinal cord nerve injury. It is an ideal surgical method for the treatment of thoracolumbar burst fracture with nerve injury.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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