胸腰段骨折伴脊髓损伤的术式选择以及疗效分析

目的:探讨胸腰段骨折伴脊髓损伤的治疗。方法:胸腰段骨折伴脊髓损伤患者39例,全部均采用前路、后路及前后联合手术入路的方法行手术治疗。其中单节段受累35例,T₁₁ 5例、T₁₂ 15例、L₁ 15例。双节断受累4例、T₁₁和T₁₂ 3例、T₁₂L₁ 1例。结果:所有的脊髓均获得了充分的有效的减压,脊柱得到了良好的内固定,平均随访了24个月,植骨处融合良好,有1例出现了脊柱后凸畸形,有2例出现椎弓根螺钉松动,伤椎由术前的（1.6±0.3）cm恢复到术后的（3.0±0.3）cm,cobb角由术前的（27±2）°恢复到（40±3）°。结论:胸腰段骨折伴脊髓损伤的手术治疗中,前后路均为有效的方法,且各有优缺点。

Thoracolumbar Fractures with Spinal Cord Injury Surgical Options and Efficacy Analysis

Objective:To investigate the thoracolumbar fracture with spinal cord injury.Methods:thoracolumbar fractures with spinal cord injury in 39 patients,all with anterior,posterior,and combined surgical approach before and after the method of surgical treatment.Single segment of which involved 35 cases,T₁₁ 5 cases,T₁₂ 15 cases,L₁ 15 cases.4 cases involved double fault,T₁₁ and T₁₂ 3 cases,T₁₂ L₁ 1 case.Results:All of the spinal cord have received a full and effective decompression,spinal fixation has been good,with an average follow-up of 24 months,the bone graft at the fusion well,and 1 patient had a kyphosis,with 2 cases pedicle screw loose,injured vertebra from preoperative（1.6±0.3） cm to a postoperative recovery（3.0±0.3） cm,cobb angle from preoperative（27±2）°restored to（40±3）°.Conclusion:In thoracolumbar fracture with surgical treatment of spinal cord injury,anterior and posterior were effective treatment methods,and advantages and disadvantages.