CAJ | 학술논문

目的评价经后路椎体次全切除三柱固定治疗胸腰椎爆裂型骨折临床疗效.方法严重胸腰椎爆裂骨折20例,新鲜骨19例,陈旧性骨折1例.按 Denis 分类均为严重的爆裂骨折,D型12例,E型8例.均采用经后路椎体次切除、椎管内减压、椎体间植骨融合后路钉棒内固定治疗.比较手术前后 ASIA 分级变化,手术前后即刻及末次随访时伤椎前缘高度、Cobb 角及椎管容积变化,评价临床疗效.结果20例骨折脱位完全复位,无血管、神经损伤及内固定松动等并发症发生；手术前后椎体前缘高度、Cobb 角、椎管容积变化有统计学差异(P<0.05)；术后X线片及CT显示骨折复位良好,椎管减压充分.结论对于严重胸腰椎爆裂骨折经后路椎体次全切可以同时对椎管充分减压,椎体间融合和三柱固定
목적평개경후로추체차전절제삼주고정치료흉요추폭렬형골절림상료효.방법엄중흉요추폭렬골절20례,신선골19례,진구성골절1례.안 Denis 분류균위엄중적폭렬골절,D형12례,E형8례.균채용경후로추체차절제、추관내감압、추체간식골융합후로정봉내고정치료.비교수술전후 ASIA 분급변화,수술전후즉각급말차수방시상추전연고도、Cobb 각급추관용적변화,평개림상료효.결과20례골절탈위완전복위,무혈관、신경손상급내고정송동등병발증발생；수술전후추체전연고도、Cobb 각、추관용적변화유통계학차이(P<0.05)；술후X선편급CT현시골절복위량호,추관감압충분.결론대우엄중흉요추폭렬골절경후로추체차전절가이동시대추관충분감압,추체간융합화삼주고정
Objective To evaluate clinic effect of Subtotal Vertebrectomy of Spine for Treatment of Serve Thoracolumbar Burst Fractures Through three columns fixation Approach.Methods 20 patients with serve thoracolumbar burst fractures were treated with subtotal vertebrectomy, decompression, fusion between vetebral bodys and fixed with pedicle screw through posterior approach.Twenty were fresh fracture and 1 old fracture.There were Type D 12 cases,type E 8 cases according to the Denis classification system.The neurological status was compared by ASIA scoring system, and the anterior height of fractured vetebral body, the Cobb angle and the volume rate of spinal canal and final follow-up were reviewed preoperatively and post operatively.Results All fracture and dislocation was rehabilitated very well. No blood vessel, nerve injury and other complications occurred.The anterior height of fractured vetebral body restored ,volume rate of spinal canal involved,Cobb angle The changes of anterior vertebral height,Cobb angle,canal volume changes Preo- perative and postoperativ were significantly different(P<0.05);X-ray and CT showed fractures and spinal canal decompression is full. Conclusion The decompression, fusion between vetebral bodys,and three column fixing can be performd at the same time through posterior approach by subtotal vertebrectomy of spine for the serve thoracolumbar burst fractures, which is as effective as through anterior and posterior approach but less trauma.