胸腰椎爆裂型骨折的外科治疗

目的探讨胸、腰椎爆裂型骨折手术治疗方法的选择。方法采用腰椎后路短节段椎弓根螺钉内固定术治疗胸、腰椎爆裂型骨折69例,对比患者手术前后神经功能评价、影像学指标及自我满意率。结果平均随访32个月,Frankel评分平均提高1.2级;Cobb角由术前平均35°恢复至6°;椎体塌陷由术前的62%恢复至13%;19例术后CT扫描平均椎管内占位由61%恢复至32%;术后优良率(自我满意率)为72%。结论手术治疗可使患者尽早恢复日常生活,有效恢复脊柱序列及椎管容积、矫正后凸畸形,有利于胸、腰椎功能恢复。

Surgical treatment of thoracolumbar burst fractures

Objective To evaluate clinical outcome of surgical treatment for thoracolumbar burst fractures. MethodsSixty-nine cases of thoracolumbar burst fractures were treated with pedicle screw system through posterior approach. Frankel scores and Cobb angles on X-rays before and after operation were evaluated and compared.Spinal canal encroahment were compared on preoperative and postoperative computed tomography (CT) scans. ResultsThe mean follow-up period was 32 months. Frankel scores improved 1.2 grades on average. The mean Cobb angle restored from 35 degrees preoperatively to 6 degrees postoperatively, collapse of vertebra from 62% to 13% and mean spinal canal encroachment from 61% to 32% by CT scans in 19 cases. Neurological function improved in all cases, and the satisfactory rate was 72%.ConclusionSugical treatment is effective to thoracolumbar burst fractures, which can help patients recover their daily lives earlier, effectively restore the alignment and volume of spinal canal and correct the kyphosis for the recovery of thoracolumbar function