胸腰椎骨折并截瘫的前路减压内固定术

目的探讨胸腰椎骨折伴截瘫的前路减压和内固定的治疗效果。方法采用前路减压Kaneda器内固定术治疗外伤性胸腰椎骨折伴截瘫38例，比较手术前后骨折复位及神经功能恢复情况。结果获随访的33例中，除2例胸椎损伤(T6、T10)并完全截瘫、2例脊髓横断无改善外，余均有Frankel一级以上恢复。结论前路减压Kaneda内固定术具有直视下直接切除致压物，有效地解除脊髓压迫，为神经功能恢复创造了条件；保留了后柱的完整性，重建了中柱的连续性，使前路减压、内固定、植骨融合、重建脊柱稳定性得以一次完成等优点，是治疗胸腰椎骨折伴截瘫的有效方法。

Anterior Decompression and Internal Fixation for Thoracolumbar Spinal Fractures with Paraplegia

Objective To evaluate the efficiency of anterior decompression and internal fixation for thoracolumbar spinal fractures with paraplegia.Methods 38 cases of traumatic thoracolumbar spinal fractures with paraplegia were treated by the anterior decompression and internal fixation with Kaneda instrumentation,comparing the restoration of fracture vertebral bodies and nervous function pre and post operation.Results 33 cases were followed up.Most of them were improved above Frankel grade one except for 2 cases of thoracic spinal injury(T 6,T 10)with complete paraplegia,and 2 cases of transverse injury of spinal cord.Conclusion The advantages of this operation:Removing the compresser under direct vision,relieving the compression on spinal cord effectively and providing the conditions for neurologic recovery;remaining the integrality of posterior column,reconstructing the continuity of middle column,and making the anterior decompression,bone grafting,internal fixation and reconstruction of spinal stability to be performed at one-stage.It is an effective method for the treatment of thoracolumbar fractures with paraplegia.