广州医药 ›› 2016, Vol. 47 ›› Issue (5): 26-27.DOI: 10.3969/j.issn.1000-8535.2016.05.009

• 论著 • 上一篇    下一篇

后路间接减压治疗椎管占位的胸腰椎爆裂骨折

张在恒1, 朱豪东2, 厉玉杰1, 张科1   

  1. 1 深圳市宝安区人民医院骨科(脊柱外科)(深圳 518101)
    2 广州市南沙区第一人民医院骨科(广州 511400)
  • 收稿日期:2016-04-21 出版日期:2016-09-20 发布日期:2021-12-02
  • 通讯作者: 张在恒,E-mail:zzh19758@126.com

Thoracolumbar burst fracture accompanied with spinal canal compromise treated by posterior indirect decompression

Zhang Zaiheng, Li Yujie, Zhang Ke, Zhu Haodong   

  1. Zhang Zaiheng, Li Yujie, Zhang Ke. Department of Orthopedics, Baoan People's Hospital, Shenzhen 518101, China
    Zhu Haodong. Department of Orthopedics,Nansha First people's hospital,Guangzhou 510180,China
  • Received:2016-04-21 Online:2016-09-20 Published:2021-12-02

摘要: 目的 探讨无脊髓神经损伤伴有大骨块突入椎管的胸腰椎爆裂骨折后路间接减压与椎弓根固定技术的应用价值。方法 对42例无脊髓神经损伤伴有大骨块突入椎管的胸腰椎爆裂骨折患者行椎弓根螺钉内固定及后路间接减压术,未进行椎板切除,伤椎上下椎体与伤椎同时植钉进行撑开间接减压,术后随访观察伤椎椎体高度的恢复,节段后凸角的纠正,椎管内骨块复位情况以及有无神经损伤症状。结果 42例患者均获随访,术后平均随访30个月。间接减压患者伤椎前后缘高度分别是:术前53.8%、82.3%,术后91.7%、95.3%;节段后凸角分别是:术前27.1°,术后5.3°;椎管截面积术前平均51.2%,术后83.7%;术后各项指标与术前相比有差异(P<0.01)。患者术后随访均无迟发性神经损伤发生。结论 对于椎管内骨块占位但无脊髓及神经损伤的胸腰椎爆裂骨折行后路间接减压椎弓根钉内固定可以达到良好的治疗效果。

关键词: 胸腰椎爆裂骨折, 后路间接减压, 椎弓根钉内固定, 伤椎置钉

Abstract: Objective To investigate the effectiveness of posterior indirect decompression and internal fixation with pedicle screws in treating thoraclumbar burst fracture without spinal cord or nerve damage accompanied with Large bone protruding into the spinal canal. Methods 42 cases were treated with pedicle screw fixation and kept the lamina. Pedicle screws were inserted into injury vertebra and adjacent centrums, and braced them for indirect decompression at the same time. To observe the recovery of injured vertebral height, the correction of segmental kyphosis angle, the restoration of protruding bone fragment and presence of nerve injury symptoms. Results After the operation, the patients were followed up for average 30 months, by comparing indexes between preoperation and postoperation, indirect decompression patient's anterior and posterior flange height of vertebral body was 53.8% and 82.3% vs 91.7% and 95.3%, and the segmental kyphosis angle was 27.1° vs 5.3°, and the cross-sectional area of spinal canal was 51.2% vs 83.7% on average. There was a significant difference between the indexes of before and after the operation. In postoperation follow-up, no patient had delayed neurological damage. Conclusion Pedicle screw internal fixation with indirection decompression is an effective method to treat thoraclumbar burst fracture,with bone fragments in spinal canal and without nervous dysfunction.

Key words: Thoraclumbar Burst Fracture, Posterior Indirect Decompression, Pedicle Screw Internal Fixation, Injury Vertebral Pedicle Screws Fixation