正确认识和提高脊柱损伤治疗水平

脊柱损伤在脊柱外科领域中既古老又充满活力。随着各种先进诊断技术的应用和现代脊柱外科技术的快速发展及相关基础研究的深入,目前脊柱损伤的诊治水平已进入了一个全新的时代。在不断提高脊柱脊髓损伤理论认识的基础上,应规范脊柱损伤的院前救治以提高救治效果;利用CT、MRI等先进诊断技术,重新认识对脊柱损伤伤情的判断,并作为治疗方案制定及手术选择的客观依据和标准;脊柱损伤手术治疗方式的选择始终是争论的焦点,但尽可能地减少手术创伤、保留运动功能和降低并发症是手术者们始终不渝的努力方向。近年来快速发展的胸腰椎后路手术技术有成为主流术式的趋势;要充分重视预防与治疗各种并发症及伤员的早期功能康复,特别是深静脉血栓等的防治;规范减压、内固定和植骨三大手术操作技术是降低手术直接并发症的关键。

Correct realization and improvement of the treatment level for spine trauma

The spine trauma is old and active in spinal surgery.With the application of various advanced diagnostic technologies and the development of modern spinal surgery and relative basic research,the treatment of spine trauma has been coming in a new era.Based on the recognition in spinal injury,the pre-hospital first aid should be normalized so as to get better treatment.The information of CT and MRI scanning could make spinal injury to be re-recognized exactly,which have become the important objective basis for the plan of therapy and operation.Although the debates are always focused on the choice of surgical way of spine trauma,reducing surgical trauma,retaining movement function and reducing complications are the key points for surgeons.For the past few years,the posterior surgical technology of spine trended to be the main surgical way in the thoracic and lumbar trauma.Full attention must be paid to the prevention and treatment of the complications,and early functional recovery,especially to the deep vein thrombosis.The key of decreasing operation complications is to normalize the technique of decompression,internal fixation and bone graft.