胸腰椎爆裂骨折前路减压手术疗效分析

目的评价脊柱前路减压、植骨内固定手术治疗胸、腰椎爆裂骨折伴脊髓损伤的疗效。方法23例胸腰椎爆裂骨折伴脊髓损伤病例采用前路脊髓减压、植骨、前路钢板内同定术，通过术前、术后影像学对比，了解椎间隙高度、植骨融合等情况，以Frankel评定法来评价病人神经功能恢复情况。结果23例患者术后随访4～16个月，平均9．5个月，全部病例椎间植骨均牢固融合，椎间高度和生理曲度保持满意．钢板螺钉未松动．神经功能恢复良好．有效恢复率为94％。结论胸腰椎爆裂骨折伴脊髓损伤采用脊髓前路减压、植骨固定方法可使骨折减压彻底．植骨融合率高，能有效维持椎间高度和生理曲度，有利于神经功能恢复．是治疗严重胸腰椎爆裂骨折的理想方法之一。

Evaluation of the Clinical Outcome of Anterior Decompression in Thorocolumbar Burst Fracture

Objective To evaluate the outcome of anterior decompression .bone graft and internal fixation in treating thorocolumbar burst fracture and spinal iniury, Methods Anterior decompression.bone graft and anterior plate were used in 23 cases of the thorocolumbar burst fracture with spinal cord injury. We contrasted the decompression. position of grafted bone and fusion with CT scan in pre-and post-operation and the recovery of nerve function with the international evaluation system of nerve function in spinal cord injury was evaluated. Results The time of follow up was from 4 months to 16 months（average time was 9.5 montbs）. The results show that all autograft with mesh between vertebral fused very well, maintenance of intervertebral height and physiology curves and recovery of nerve were satisfied .and no plate or screw loose. Conclusion Internal fixation with anterior plate after anterior decompression and bone graft is an idea technique for severe thoracocolumbar spine burst fractures to facilicates a complete decompression.promote bone fusion,maintenance intervertebral height .physiology curve and recovery of nerve.