选择性椎管减压钉杆角椎弓根内固定系统治疗胸腰椎爆裂骨折

目的　采用选择性椎管减压钉杆角椎弓根内固定系统治疗胸腰椎爆裂骨折 30例。方法　依据骨折类型、椎管狭窄程度 ,碎骨块状态进行选择性椎管减压 :轻度椎管狭窄则行间接椎管减压 ,若有神经损伤症状同时作椎板减压 ;严重椎管狭窄、后柱损伤、后纵韧带损伤碎骨块游离、骨块旋转则间接椎管减压 +椎板减压 +脊髓前减压。结果　 30例中 2 9例减压充分 ,30例固定牢固 ,神经恢复好转率占 70 %。结论　认为在采用椎弓根螺钉治疗胸腰椎爆裂骨折时 ,应根据骨折类型、椎管狭窄程度、碎骨块状态进行选择性椎管减压。

Thoracolumbar Burst Fracture Treated with APF and Selective Decompression

Objective This article presents 30 cases of thoracolumbar burst fracture treated by APF and selective decompression Methods Spinal canal decompression was selected according to the type of fracture,the degree of stenosis and the status of bone fragments Indirect decompression was selected when stenosis is mild,but laminectomy was performed simultaneously if neural deficiency presence Indirect decompression,laminectomy and decompression of anterior aspect of cord were performed at the same time in case of severe stenosis,posterior column injure,posterior longitudinal rupture,free bone fragments or rotation of fragments Results Twenty-nine of the thirty patients had adequate decompression Stable fixation was achieved in all thirty cases Neural recovery rate was seventy percent Conclusion Authors consider that when thoracolumbar burst fracture was treated with APF,selective decompression should be considered in respones to the type of fracture,the degree of stenosis and the status of bone fragments