舌路椎管前后方同时减压治疗伴脊髓损伤的胸腰段爆裂骨折的临床研究

目的探讨后路椎管前后方同时减压治疗伴脊髓损伤的胸腰段爆裂骨折的临床疗效。方法选取本院2009年2月～2011年5月收治的伴脊髓损伤的胸腰段爆裂骨折患者23例，均采用后路椎管前后方同时减压治疗，比较患者治疗前后的临床指标。结果手术均顺利完成，手术时问为（173．6±32．8）min，术中出血量为（649．5±203．1）mL，术后24h伤口引流量为（297．2±56．3）mL，骨折愈合时间为（16．8±3．4）周。术后患者发生感染2例，术后并发症发生率为8．7％。术后伤椎前缘高度、伤椎后缘高度、椎管容积率均明显大于术前，术后Cobb角明显小于术前，差异均有统计学意义（P〈0．05）。术后Frankel分级评定情况明显好于术前。结论后路椎管前后方同时减压治疗伴脊髓损伤的胸腰段爆裂骨折具有显著的临床疗效，减压彻底，骨折复位效果好，内固定更为牢靠，值得临床推广使用。

Clinical research on thoracolumbar burst fracture combined with spinal cord injury in the treatment with anterior and posterior decompression of posterior vertebral canal

Objective To investigate the clinical efficacy on thoracolumbar burst fracture combined with spinal cord injury in the treatment with anterior and posterior decompression of posterior vertebral canal.Methods Twenty-three patients with thoracolumbar burst fracture and spinal cord injury were selected in our hospital from February 2009 to May 2011.All patients were treated by anterior and posterior decompression of posterior vertebral canal.Clinical indexes were compared before and after the treatment.Results Operation was successfully completed.Operation time was(173.6±32.8) min.Amount of intraoperative bleeding was(649.5±203.1) mL.24 h postoperative wound drainage was(297.2±56.3) mL.Fracture healing time was(16.8±3.4) weeks.2 patients occurred postoperative infection.Complication rate was 8.7%.Vertebral height of the front edge,vertebral height of the back edge,spinal canal volume rate after operation were significantly higher than those before operation.Cobb angle after operation was smaller than that before operation.The differences were statistically significant(P < 0.05).Frankel grading after operation was obviously better than that before operation.Conclusion Anterior and posterior decompression of posterior vertebral canal in the treatment for thoracolumbar burst fracture and spinal cord injury has obvious clinical curative effect,which can complete decompression.Fracture reduction effect is good,while inner fixation is firmer.That is worthy of clinical use.