手术治疗椎管占位无神经损伤胸腰椎爆裂性骨折疗效分析

目的探讨椎管占位无神经症状的胸腰段爆裂性骨折手术治疗效果。方法对34例确诊为椎管占位无神经症状的胸腰椎爆裂性骨折患者采用后路椎弓根螺钉内固定复位融合技术进行治疗。结果本组34例平均随访26个月,术后X线片、CT显示复位、固定良好,椎体内、外植骨均获得骨性融合,Cobb’s角由术前平均26.3°恢复到术后平均4.7°,椎体前缘高度由术前平均43.4%恢复到术后的平均95.8%。术后均未出现神经功能障碍,无感染,无断钉、断棒及螺钉松动等并发症。结论严格掌握胸腰椎爆裂骨折的手术适应证和熟练操作程序,经后路椎弓根内固定系统治疗椎管占位无神经损伤的胸腰椎爆裂骨折,可有效地矫正和防止脊柱后凸畸形,避免晚期腰背痛及迟发性神经损伤等后遗症,减少卧床时间,为早期康复创造条件。

Clinical Analysis of Occupancy Non-surgical Treatment of Spinal Nerve Injury in Thoracolumbar Burst Fractures

Objective To explore the spinal canal without neurological symptoms occupancy thoracolumbar burst fracture treatment.Methods Totally 34 patients diagnosed as spinal canal without neurological symptoms of occupancy thoracolumbar burst fracture using pedicle screw fixation reset fusion treatment.Results Totally 34 patients with mean follow-up 26 months after x-ray film,CT showed reduction,fixed good,vertebral body inside and outside have received bone graft fusion,Cobb’s angle from preoperative average of 26.3 ° to return to an average of 4.7 °,vertebral body height from the leading edge of preoperative average of 43.4% back to the postoperative average of 95.8%.Conclusion Strict control of thoracolumbar burst fracture of the surgical indications and skilled operating procedures,posterior pedicle fixation system for treatment of spinal nerve injury-free occupancy of thoracolumbar burst fracture,which can effectively correct and prevent the kyphosis to avoid the late delayed back pain and nerve damage or other consequences,reduce bed time,to create conditions for early rehabilitation.