CAJ | 학술논문

目的观察改良胸腰椎前路手术径路及内固定技术治疗胸腰椎爆裂骨折的效果.方法胸腰椎爆裂骨折患者52例,其中新鲜骨折47例,陈旧骨折5例,均采用倒"L"形手术径路,电凝烧结或结扎椎体节段血管,切除伤椎相邻上、下椎间盘,保留大部分软骨终板后置放椎体螺钉,取髂骨块,冉切除伤椎行椎管减压,撑开椎间隙行髂骨块植骨,置放钢板矫形固定.结果其中新鲜骨折47例,术中出皿300～700 ml,平均490 ml,手术时间120～210 min,平均156 min;陈旧性骨折5例,术中出血800～1100 ml,平均1050 ml,手术时间210～240 min,平均217 min.48例患者术后随访9～18个月,平均13个月,脊柱序列均恢复止常,无植骨块塌陷及高度丢失现象,无内固定失败;脊髓神经功能均有不同程度的恢复.结论改良胸腰椎前路手术径路及内固定技术可明显减少术中出血,缩短手术时间,减轻手术创伤,降低了术后并发症的发生率.
목적 관찰개량흉요추전로수술경로급내고정기술치료흉요추폭렬골절적효과.방법 흉요추폭렬골절환자52례,기중신선골절47례,진구골절5례,균채용도"L"형수술경로,전응소결혹결찰추체절단혈관,절제상추상린상、하추간반,보류대부분연골종판후치방추체라정,취가골괴,염절제상추행추관감압,탱개추간극행가골괴식골,치방강판교형고정.결과 기중신선골절47례,술중출명300～700 ml,평균490 ml,수술시간120～210 min,평균156 min;진구성골절5례,술중출혈800～1100 ml,평균1050 ml,수술시간210～240 min,평균217 min.48례환자술후수방9～18개월,평균13개월,척주서렬균회복지상,무식골괴탑함급고도주실현상,무내고정실패;척수신경공능균유불동정도적회복.결론 개량흉요추전로수술경로급내고정기술가명현감소술중출혈,축단수술시간,감경수술창상,강저료술후병발증적발생솔.
Objective To observe modified anterior approach incision and inner fixation technique for thoracolumbar vertebral bursting fracture. Methods Inverted "L" shape Incision was applied, meanwhile vertebral segment vessels was cut or ligated and intervertebral disc of fracture vertebra was removed. Results Fifty-two cases with thoracolumbar vertebral bursting fracture were treated. The incisions ranged between 14 and 20 cm (mean 17 cm). Forty-seven cases got fresh fracture and blood loss was 300-700 ml (mean 490 ml). The operation duration was 120-210 min (mean 156 min). 5 cases had old fracture with blood loss 800-1100 ml(mean 1050 ml). The operation duration was 210-240 min. During follow-ups, the bone graft sinking and loss of deformity correction was not found. The spinal nerves function gained different levels of recovery. Conclusion The modified anterior approach incision and inner fixation technique for thoracolumbar vertebral decrease blood loss, shorten operating time with reduced trauma and less complications.