胸腰椎爆裂性骨折椎管内骨块复位的解剖学分析

目的：：探讨胸腰椎爆裂型骨折椎管内骨块复位的解剖学基础。方法：选择20具成年男性尸体标本并随机分成4组,正常对照组(D1)、单纯后纵韧带模型组(D2)、单纯椎间盘纤维环模型组(D3)、复合切除后纵韧带和椎间盘纤维环模型组(D4),解剖并测量各组骨折块复位角度及生物学力度,对比各组骨折块复位的差异变化,探索后纵韧带和椎间盘纤维环的完整性对于骨块复位的作用意义。结果：各模型制作成功,D1组椎管内骨块复位良好；D2、D3组复位相对较好,但 D3组复位效果略好于 D2；D4组复位效果极差,突入椎管内骨块几乎不复位。结论：在胸腰椎爆裂性骨折时,后纵韧带及椎间盘纤维环的完整性对椎管内骨块复位具有重要作用,为相关手术治疗提供有利依据。

Anatomical analysis of Fracture of Bone Fragment in Spinal Canal of Reduction of Thoracolumbar Burst

Objective:To explore the anatomical basis of thoracolumbar spinal bone mass reduction of fracture.Methods:20 adult male cadaveric specimens were selected and randomly divided into 4 groups-the normal control group (D1),simple posterior longitudinal ligament model group (D2),simple disc annulus model group (D3),composite resection of posterior longitudinal ligament and annulus fibrosus of in-tervertebral disc model group (D4),Then the fracture block reset angle and biological dynamics were dissected and measured,and the different changes of the frature block set among groups were compared.Furthermore,the role of the integrity of the posterior longitudinal ligament and annulus fibrosus of intervertebral disc to bone block reset was explored.Results:each model was made successfully,the bone fragment in spinal canal of the A1 group reset the best;D2 and D3 groups reset relatively good,but the reduction effect of group D3 was better than D2;the reduction effect of D4 group was rather bad,the part protruding into the spinal canal bone almost not reset.Conclusion:When the thoracic and lumbar burst fractures,the integrity of the posterior longitudinal ligament and annulus fibrosus of intervertebral disc has an important significance for spinal bone fracture reduction,which provides a basis for the related operation treatment.