椎管侧前方减压内固定治疗胸腰段脊柱骨折合并脊髓损伤

目的阐述椎管侧前方减压在胸腰椎骨折中的应用及疗效。方法对本院2001~2004年胸腰椎骨折98例行侧前方减压内固定治疗,其中男65例,女33例。随访时间4个月~3a,平均2.5a。结果不全瘫患者术后Frankel至少进步一级,所有患者术后椎体稳定性好,无继发性椎体压缩。结论椎管侧前方减压治疗胸腰椎骨折具有减压直接彻底,对后柱韧带复合体干扰小的优点;以中柱为轴心的重建符合脊柱的生物力学特征;采用骶棘肌腰方肌间隙入路损伤小,出血少。

Treatment of the Thoracolumbar Fractures and Spinal Injuries with Anterolateral Decompression and Fixation

Objective To explore the effects of anterolateral decompression and fixation on the thoracolumbar fractures and spinal injuries. Methods 98 cases were reviewed who treated with anterolateral decompression and fixation in the thoracolumbar fractures since 2001 to 2004, including male 65 cases, female 33 cases. The followed-up time was 4 months to 3 years with an average time of 2.5 years. Results Of the patients with incomplete paralysis improved at least grade one after operation according to Frankel classification. All patients achived a good centrumical stability after operation, none of the secondary compression of the centrums were observed. Conclusion The anterolateral decompression was an direct and thorough treatment to the thoracolumbar fractures, which had little disturbance to the posthole ligament complex. The reconstruction in the axes of the midpole was accordance with the spinal biomechanical characters. There were obvious advantages of less injury and less bleed through the space between erector spine muscles and quadratus lumborum muscles.