前路减压Synex人工椎体重建治疗陈旧性胸腰椎骨折

目的探讨前路减压Synex人工椎体重建治疗陈旧性胸腰椎骨折合并神经损伤的临床疗效。方法采用侧前方入路椎体次全切除减压及Synex人工椎体重建治疗18例初次后路手术疗效不佳或失败的患者，术后观察神经功能恢复情况及手术椎节的稳定性。结果随访1-4年。依据Frankel分级评价患者神经功能，除1例B级及1例D级患者无改变外，其余患者均有1-3级恢复。术后X线片定期随访观察，椎体高度无明显丢失，人工椎体稳定，未发现位移。结论侧前方入路减压及Synex人工椎体重建可解除脊髓压迫、改善神经功能及恢复脊柱稳定性，是一种治疗陈旧性胸腰椎骨折合并脊髓损伤的理想手术方式。

Surgery treatment of later thoracolumbar fracture through anterior approach with Synex reconstruction

Objective To observe clinical effect of treatment of later thoracolumbar fracture with anterior decompression and Synex artificial vertebra reconstruction. Methods Eighteen patients with thoracolumbar fracture, who had undergone posterior decompression and stabilization in the first stage and had poor results, were treated by anterior decompression and reconstruction with Synex artificial vertebra through anterolateral approach. The recovery of neurological function and stability of fused segments were investigated after operation. Results All cases were followed-up for 1-4 years. According to Frankle grading, neurological function was improved by 1-3 grades except 2 cases unchanged (1 at grade B and 1 at grade D peroperative). Maintenance of the segmental height and stability of the implants were observed on the postoperative radiographs during the follow-up. Conclusion Anterior decompression and Synex artificial vertebra reconstruction through anterolateral approach provides advantages of improvement of neurological function and stabilization of the segments. This technique is safe and effective to treat later thoracolumbar fracture with spinal cord injury.