胸椎骨折39例治疗分析

目的探讨胸椎骨折的损伤特点及治疗。方法对39例胸椎骨折患者的临床资料作回顾性分析。稳定压缩骨折10例单纯保守治疗,不稳定压缩骨折15例行后路减压植骨融合加椎弓根螺钉内固定,爆裂骨折10例行前路减压植骨融合Z-plate前路钢板内固定;骨折脱位3例及爆裂脱位1例采用前后联合入路。结果全部病例均获随访,时间6~24个月,平均12个月。神经功能明显改善,术后6个月植骨融合率达100%,未见内植物松动及断裂现象。结论胸椎骨折的治疗应根据骨折的类型及稳定性,对于不稳定骨折应行融合及内固定手术,合并有不完全性脊髓损伤者还应同时行减压手术。

Clinical features and treatment of thoracic spine fracture

Objective To study the characteristics and treatment of thoracic spine fractures.Methods Thirty-nine patients with thoracic spine fractures were retrospectively reviewed.Ten patients with stable compressed fractures underwent simple conservative treatment,15 patients with nonstable compressed fractures underwent posterior procedure,10 patients with burst fracture underwent anterior procedure,3 patients with fracture-dislocations and 1 with burst-dislocations underwent combined procedures.Results All patients were followed-up from 6 to 24 months with an average of 12 months.Neurological deficits were significantly improved postoperatively.A stable osteal fusion according to radiological criteria was achieved in all cases 6 months postoperatively.There was no implants break or loosening.Conclusion The treatments are selected according to classification and stability of thoracic spine fractures.Fusion and instrumentation is indicated when the fractures are unstable,while patients with incomplete lesion of the spinal cord may be the candidates for supplemented decompression.