CAJ | 학술논문

目的：探讨后路椎体次全切除椎间支撑植骨术治疗胸腰椎爆裂骨折的疗效。方法：采用后路椎体次全切除椎间支撑植骨治疗胸腰椎爆裂骨折患者19例,术后1周、3个月、6个月、12个月行X线片及三维CT扫描,观察椎间高度、椎间支撑体及周围植骨融合情况、椎管减压程度及脊髓神经功能恢复。结果：19例均顺利完成手术,随访6~36个月,术后1周X线片未见支撑体明显移位,脊髓神经功能均有不同程度恢复；术后3个月X线片、CT扫描示椎管通畅无占位,支撑体及周围植骨与临近椎体间隙模糊；术后6个月、12个月X线片、CT扫描示18例患者支撑体及周围植骨与邻近椎体有连续骨小梁形成,1例支撑与椎间无连续骨小梁通过,但周围植骨已骨性愈合；1例支撑倾斜(矢状面或冠状面倾斜角度均<10°)；19例Frankel分级均明显改善。结论：后路椎体次全切除椎间支撑植骨减压彻底,有利于脊髓神经恢复,支撑体植骨有利于恢复脊柱稳定性,降低内固定松动和断裂的可能。
목적：탐토후로추체차전절제추간지탱식골술치료흉요추폭렬골절적료효。방법：채용후로추체차전절제추간지탱식골치료흉요추폭렬골절환자19례,술후1주、3개월、6개월、12개월행X선편급삼유CT소묘,관찰추간고도、추간지탱체급주위식골융합정황、추관감압정도급척수신경공능회복。결과：19례균순리완성수술,수방6~36개월,술후1주X선편미견지탱체명현이위,척수신경공능균유불동정도회복；술후3개월X선편、CT소묘시추관통창무점위,지탱체급주위식골여림근추체간극모호；술후6개월、12개월X선편、CT소묘시18례환자지탱체급주위식골여린근추체유련속골소량형성,1례지탱여추간무련속골소량통과,단주위식골이골성유합；1례지탱경사(시상면혹관상면경사각도균<10°)；19례Frankel분급균명현개선。결론：후로추체차전절제추간지탱식골감압철저,유리우척수신경회복,지탱체식골유리우회복척주은정성,강저내고정송동화단렬적가능。
Objective:To explore the efficacy of posterior corpectomy combined with intervertebral bone graft in the treatment of thoracolumbar burst fracture. Methods:Nineteen patients with thoracolumbar? burst? fractures were treated with posterior corpectomy combined with intervertebral bone graft. The X-ray and 3-D CT scanning in all cases were performed at postoperative 1 week,3 months, 6 months and 12 months. The intervertebral height, intervertebral strut, periphery bone graft fusion, spinal canal decompression and spinal nerve function recovery of all patients were observed. Results:The operations in 19 patients were successful,all patients were followed up for 6 to 36 months. At postoperative 1 week,no obvious displacement in strut was observed in X-ray film,and part spinal nerve function recovered. At postoperative 3 months,no space-occupying lesion and vague interspace between the strut and periphery bone graft and adjacent vertebrae were observed by X-ray film and CT scanning. At postoperative 6 and 12 months, the continuous trabeculae formations between the strut and periphery bone graft and adjacent vertebrae in 18 cases,no continuous trabeculae formations between the strut and vertebrae and periphery bone graft union in 1 case and oblique strut( the obliquity at sagittal or coronal plane was less than 10°) in 1 case were detected by X-ray film and CT scanning. The Frankel grading in 19 cases were obviously improved. Conclusions:The posterior corpectomy combined with intervertebral bone graft can completely decompress, and be conducive to the spinal nerve function recovery. The strut bone graft can be conducive to the recovery of spinal stability,and reduce the possibility of the loosening and fracture of internal fixation.