后路内固定并前路减压植骨治疗胸腰椎爆裂骨折

目的探讨经后路钉棒系统内固定并前路减压植骨融合治疗胸腰椎爆裂骨折的疗效。方法对27例胸腰椎爆裂骨折患者行后路手术,一期或二期经胸膜外或腹膜后入路,前路彻底减压,取肋骨或髂骨椎间植骨。结果 27例均获随访,时间9~36(16.4±6)个月。椎间植骨均获成功。随访期间未见后凸畸形复发或加重,无断钉;神经功能较术前明显改善。结论后路内固定联合前路减压植骨治疗胸腰椎爆裂骨折,前路减压直接彻底,脊柱稳定性可靠,可获得神经功能的最大改善。

Posterior internal fixation and anterior decompression and bone graft for treatment of thora-columbar burst fractures

Objective To explore the posterior screw rod system fixation and anterior decompression and curative effect of treatment of thoracolumbar burst fracture of the bone fusion. Methods 27 patients with thoracolumbar burst fracture underwent posterior operation, one or two stage by extrapleural and retroperitoneal approach, anterior decom-pression, rib or iliac bone graft. Results 27 cases were followed up for 9~36 （16. 4 ± 6） months. Intervertebral bone grafting was successful. During the follow-up period, no kyphosis recurrence or aggravation, no broken nails were found, nerve function was obviously improved than before the operation. Conclusions Posterior internal fixa-tion and anterior decompression and bone graft operation for the treatment of thoracolumbar burst fracture provide an-terior decompression and spinal stability directly and thoroughly, and reliable, the maximum improvement of nerve function can be obtained.