保留后柱稳定手术治疗胸腰椎爆裂骨折并神经损伤

目的探讨保留后柱稳定性的减压方式配合内固定、植骨融合在胸腰椎新鲜爆裂骨折并神经损伤治疗中的应用价值。方法对89例胸腰椎新鲜爆裂骨折并神经损伤行保留后柱稳定性的减压方式配合内固定、植骨融合术,其中男55例,女34例;年龄18~57岁,平均34岁。术前均呈不同程度的不完全性瘫痪。按Frankel分级,A级8例,B级32例,C级28例,D级21例。结果术后进行6~24个月(平均12个月)随访。术后症状明显缓解、脊髓功能明显改善者占89.9%(80/89),术后6个月植骨融合率为100%。无钛棒、螺帽和螺钉松动或断裂现象。结论应用保留后柱稳定性的减压方式配合脊柱内固定、植骨融合治疗胸腰椎新鲜爆裂骨折并神经损伤,具有手术干扰小、创伤小、减压彻底、术后脊柱稳定性好、植骨牢固,融合率高等优点。

Decompression and Internal Fixation in Fresh Thoracolumbar Burst Fracture with Nerve Injury Re- taining the Stability of Posterior Column

Objective To explore the application value of decompression and internal fixation in fresh thoracolumbar burst fracture with nerve injury retaining the stability of posterior column. Methods 89 cases of thoracolumbar brnst fracture with nerve injury were treated with decompression and internal fixation, bone graft fusion while preserving posterior column stability. The patients were followed up for 6 ~ 24 months （ 12 months in average）. Results After operation symptoms were relieved, the spinal cord function improved significantly in 89.9% patients （ 80/89 ）. 6 months later the fusion rate was 100%. No im- pant loosening and fracture happened. Conclusion The decompression retaining stability of the posterior column with spinal internal fixation ,bone graft fusion is a good choice in a fresh burst thoracolumbar fracture and nerve injury.