CAJ | 학술논문

目的探讨脊柱损伤的治疗方法,对手术操作要点及相关问题提出见解.方法本组205例,均采用后入路,在C臂引导下操作,先打入椎弓根螺钉、椎管减压、体位过伸复位、上连接杆并撑开、将骨块回敲,最后椎旁植骨.结果术后X线复查,椎体的高度、形态及脊柱生理弯曲基本恢复.随访14～36个月,迟发感染4例,螺钉松动7例,断钉6例(14钉),断棒1例,无继发神经损伤及其它并发症.结论后路椎弓根螺钉内固定操作容易,能充分扩大椎管达到减压目的 ;结合术中脊柱过伸位复位,有利于恢复伤椎高度,获得更好效果.
목적 탐토척주손상적치료방법,대수술조작요점급상관문제제출견해.방법 본조205례,균채용후입로,재C비인도하조작,선타입추궁근라정、추관감압、체위과신복위、상련접간병탱개、장골괴회고,최후추방식골.결과 술후X선복사,추체적고도、형태급척주생리만곡기본회복.수방14～36개월,지발감염4례,라정송동7례,단정6례(14정),단봉1례,무계발신경손상급기타병발증.결론 후로추궁근라정내고정조작용역,능충분확대추관체도감압목적 ;결합술중척주과신위복위,유리우회복상추고도,획득경호효과.
Objective To discuss the surgical treatment of spinal injury, and provide insights on key points and related issues for operations. Methods Two hundred and five cases of spinal fracture were treated through posterior surgical treatment. Under C-arm X-ray monitoring, surgeries had been operated on pedicle screws insertion, vertebral canal decompression, over-extending reduction position, and placed the connecting rod, knocked in the bone graft and finally transplanted the paraspinal bone. Results After operations , the height and morphology of vertebral bodies and spinal physiological curvature were basically recovered analyzed by X ray examination. The follow-up results (in the average of 14 to 36 months) indicated that there were 4 cases of delayed infection, 7 cases of loosen screw, 6 cases of broken screw (14 screws)and 1 case of broken stick, with no secondary nerve injury or other syndromes. Conclusion The vertebral pedicle screw internal fixation manipulated easily, which could sufficiently enlarge vertebral canal in order to decompression. In addition, during the operation, together with over-extending reduction position is beneficial to regain the height of fractured vertebral bodies.