胸腰椎爆裂骨折几种入路的对比研究

目的:评价不同的手术入路治疗胸腰椎爆裂骨折的优缺点。方法:采用三种不同的手术入路治疗腰椎爆裂骨折46例,其中经后路32例,前路10例,前后联合入路4例。采用ASIA标准评定神经功能恢复情况,通过影像学检查比较伤椎和Cobb角的矫正及丢失,评估椎管减压范围、植骨块位置及愈合情况。结果:46例随访8～36个月,平均13个月,术前不完全性损伤的40例患者神经功能恢复1级或1级以上。脊髓神经功能术前为A级6例,术后均无恢复。结论:胸腰椎爆裂骨折术式的选择取决于脊柱稳定性、神经损伤情况以及椎管内占位程度。

Research of several appraochs for thoracic and lumbar vertebra fracture

Objectlve To Evaluate advantages and disadvantages of different approachs for thoracic and lumbar vertebra fracture. Method There are 46cases for three approachs for thoracic and lumbar vertebra fracture including 32cases for posterior approach , 10cases for anterior approach ,4cases for anterior and posterior approach .Evaluating nerve function recovering on ASIA ,Comparing correction and lose of fractured vertebra and Cobb angel through imagination..Evaluating depressing range for vertebra canal , position of implanting bone and fracture recovering. Results There are 46 cases follow-up for 8-36 months, nerve function of recover of 40cases with nerve function incomplete injure anterior operation recover 1 grade or more,6cases for A grade anterior operation recover nothing. Conclusion Selecting approach is according to spinal stability ,injury of nerve and grade of protrusion of bone in the vertebra canal.