胸腔镜辅助下前路减压内固定治疗胸腰椎骨折的手术策略

目的探讨胸腔镜辅助下前路减压内固定治疗胸腰椎骨折的手术策略及其临床应用疗效。方法笔者在胸腔镜辅助下小切口对19例胸腰椎骨折实施前路椎管减压、植骨、内固定手术。经胸腔11例,经腹膜外8例。结果术后影像学检查显示椎管减压彻底、植骨充分、内固定效果确切。不完全瘫痪14例神经功能均有明显改善,肌力恢复到2～4级。5例完全性瘫痪病例中2例肌力恢复到4、5级,1例肌力恢复到2级,2例无改善。神经功能按ASIA分级法:A级2例,C级1例,D级3例,E级13例。结论胸腔镜辅助下小切口行胸腰椎前路手术治疗胸腰椎骨折的方法,弥补了传统的胸腰椎前路手术创伤较大的缺点,其创伤小、恢复快,可得到早期的康复治疗,临床疗效满意。

Surgical Strategy of Thoracoscopic Assisted Anterior Decompression and Internal Fixation for Thoracolumbar Spine Fracture

Objective To investigate the clinical use and the incision choice in thoracoscopic anterior surgery for thoracolumbar fracture.Methods Nineteen patients with thoracolumbar spine fracture underwent thoracoscopic anterior spine operation.All cases were treated with anterior decompression autograft and internal fixation with anterior plate fixation system.The incision of the operation was changed.Traditional incision wounded patients severely and the treatment for T12 fracture was difficult.The incision was se...