胸腰椎脊柱脊髓损伤的手术治疗

本文报告68例胸腰椎骨折脱位伴截瘫患者,采用作者改良设计的“经椎弓根椎体后份切除术”的治疗结果。该术特点:手术途径采取胸腔外和腹膜后间隙显露伤椎,减少了对胸腹腔脏器的干扰;术中根据12肋和胸12椎体定位而不需用X线监控或摄片;术中将伤椎上、下正常椎体后缘连线作为判断切除伤椎后份的标记线,既可避免盲目切除伤椎,又能有效地解除脊髓受压。68例患者通过7～26个月的随访,神经功能按Frankel分级标准,较术前改善Ⅰ～Ⅱ级。作者认为该术式创伤较小,并发症少,减压准确,对脊柱稳定性损害小。

Operative Treatment for the Thoracolumbar Vertebral Injuries with Paraplegia

A new method "displaced posterior partial vertebrectomy the Pediculus arcus vertebrae" designed by the authors was reported and 68 cases of the thoracolumbar vertebral fracture - dislocation with paraplegia were treated successfully. The characteristics of the method: An extrapleural or retroperitoneal exposure is adopted, which is aid to reduce complications; Location of injuried segment is according to the twelfth rib and vertebra without X-ray film during the operation; In order to decompress successfully and avoid resecting the vertebra blindly, a line between the posterior edges of the upper and the lower vertebra is used as a symbol to determine the range of decompression. After follow-up of 7 to 26 months, it is shown that the neural function in all 68 cases has improved in varying degree. The authors believe that the method has the following advantages: less trauma and complications from operation, precise decompression can be made with less injury to the stability of the spine so that internal fixation is unnecessary.