CAJ | 학술논문

目的探讨后路椎板开窗减压结合椎弓根固定治疗有椎管侵占的胸腰椎爆裂骨折的可行性. 方法选择2005年1月-2008年12月胸腰椎骨折AO分型A3型骨折患者52例,椎管侵占通过伤椎椎板开窗,将骨折块推移复位,椎弓根固定,不需要椎间植骨融合.对所有患者椎管侵占、椎体前缘高度丢失、伤椎椎体Cobb角度改变及神经功能损害行术前、术后对比. 结果术后随访24个月.椎管侵占从术前的(68.3±l5.1)％恢复至术后的(11.5±3.9)％(P＜0.05);伤椎后凸Cobb角由术前的(32.5±3.2)°恢复至术后的(4.9±0.6)°(P＜0.05);椎体高度丢失由术前的(50.1±5.6)％恢复至术后的(85.5±5.1)％(P＜0.05).末次随访时,椎体骨折愈合,椎体高度无明显丢失,患者神经功能均有恢复. 结论椎板开窗减压结合椎弓根固定技术治疗A3型骨折可以获得良好的影像学和临床结果,是治疗A3型骨折的一个可靠选择.
목적 탐토후로추판개창감압결합추궁근고정치료유추관침점적흉요추폭렬골절적가행성. 방법 선택2005년1월-2008년12월흉요추골절AO분형A3형골절환자52례,추관침점통과상추추판개창,장골절괴추이복위,추궁근고정,불수요추간식골융합.대소유환자추관침점、추체전연고도주실、상추추체Cobb각도개변급신경공능손해행술전、술후대비. 결과 술후수방24개월.추관침점종술전적(68.3±l5.1)％회복지술후적(11.5±3.9)％(P＜0.05);상추후철Cobb각유술전적(32.5±3.2)°회복지술후적(4.9±0.6)°(P＜0.05);추체고도주실유술전적(50.1±5.6)％회복지술후적(85.5±5.1)％(P＜0.05).말차수방시,추체골절유합,추체고도무명현주실,환자신경공능균유회복. 결론 추판개창감압결합추궁근고정기술치료A3형골절가이획득량호적영상학화림상결과,시치료A3형골절적일개가고선택.
Objective To detect the possibility of posterior laminar fenestration combined with screw instrumentation for treatment of thoracolumbar burst fracture with canal encroachment.Methods Between January 2005 and December 2008,52 patients with AO-A3 thoracolumbar fracture underwent laminar fenestration to achieve canal decompression and pedicle screw instrumentation without interbody fusion.Canal encroachment,loss of anterior vertebral height,Cobb' s angle,and neurologic outcome were measured before and after operation.Results All patients were followed up for 24 months.Canal encroachment improved from preoperative (68.3 ± 15.1)％ to postoperative (11.5-3.9)％ (P ＜ 0.05).Cobb' s angle reduced from preoperative (32.5 ± 3.2) ° to postoperative (4.9-± 0.6) ° (P ＜ 0.05).Loss of anterior vertebral height restored from preoperative (50.1 ± 5.6) ％ to postoperative (85.5 ± 5.1) ％ (P ＜ 0.05).At the final follow-up,neurological recovery and fracture healing with no apparent vertebral height loss were noted for all patients.Conclusion Flaminar fenestration combined with pedicle screw stabilization attains good radiographic and clinical results in treating patients with AO-A3 thoracolumbar burst fracture.