胸腰椎爆裂骨折后路手术方法进展

目的：后路手术复位内固定手术已被广泛接受，但对于治疗胸腰椎爆裂骨折的方法还存在较多争论。本文对胸腰椎爆裂骨折后路手术方法进行综述，以期对临床手术治疗提供参考。方法：网上搜索PubMed，CNKI等引擎，查阅有关胸腰椎爆裂骨折的文献资料进行分析。结果：后路手术方法包括后路减压经伤椎上下椎体内固定，后路减压经伤椎椎弓根内固定，后路减压伤椎植骨内固定，后路减压骨水泥成形内固定术等。结论：目前对于具体后路术式选择标准上还存在争议。经伤椎椎弓根螺钉连同上下相邻椎弓根内固定较传统后路方法能更有效地复位，更加稳定。

Progress on the Posterior Operational Treatment of Thoracolumbar Burst Fractures

Objective：To summarize the methods of posterior operational treatment for thoracolumbar burst fractures with the expectation of providing references for clinical treatment. Methods：To review and analyze clinical data related to the thoracolumbar burst fractures from PubMed and CNKI databases. Results：Posterior operation ineluds traditional management with 4 pedicle screws, posterior depression and internal fixation, posterior internal fixation plus bone grafting or bone cement grafting into the fractured vertebra, and intermediate screws in short segment pedicular fixation, et al. Conclusions： Different criteria are advanced for the man- agement of thoracolumbar burst fractures, yet none of the existing criteria are generally accepted. The new developed technology ＂intermediate screws in short segment pedicular fixation＂ is well accepted by some experts, and the addition of intermediate screws at the level of a burst fracture significantly increases the stiffness of a short segment pedicular fixation.