胸椎；腰椎；前路手术；骨折_

前路减压内固定治疗胸腰段脊柱骨折

http://www.100md.com 《河北医药》 2006年第12期

胸椎；腰椎；前路手术；骨折,,胸椎；腰椎；前路手术；骨折,1资料与方法,2结果,3讨论

     【摘要】目的讨论胸腰段骨折的前路手术方法和临床疗效。方法对45例严重胸腰段骨折的患者采用左侧经胸膜后、腹膜后或胸腹联合切口入路椎管前方减压去除位于后纵韧带前方的致压物如骨折块及破裂后突的椎间盘组织。结果 45例均无术中并发症。术后随访6～24个月，无脊髓再损伤病例，伤椎部位脊椎曲度恢复正常，无明显侧凸或后凸畸形发生；术后3个月复查植骨愈合良好，无植骨块塌陷及高度丢失现象，随访期内无植骨不愈合或钢板螺钉断裂现象。结论胸腰段骨折前路入路安全可靠，对脊髓减压彻底，有利于神经恢复，重建脊柱稳定性好，为患者顺利恢复创造条件。

    【关键词】胸椎；腰椎；前路手术；骨折

    Anterior approach operation of thoracolumbar fractures WU Peizeng,LIN Jindui,HUANG Jianming et al.Department of Orthopaedics,The Quanzhou Hospital of the Traditional Chinese Medicine, Quanzhou 362000

    【Abstract】 Objective To investigate the surgical method and clinical effects of the anterior approach operation in the treatment of thoracolumbar vertebral fractures.Methods Fiftyfive cases of bursting fracture of thoracolumbar vertebral body were treated with the operation of anterior decompression, bone grafting and internal fixation by the anterior approach.The MRI combined with clinical examination,Xray,CT results were taken as selection criteria of treatment.Results The operation time is 2～2.5 hours. All patients were followedup with an average period of 18 months (ranged,6～24 months).No aggravation of nerve injury appeared in 45 cases.Xray manifested good fusion,no broken nails and no recurrence of kyphosis in all cases.Conclusion Anterior decompression operation is an effective way for severe thoracolumbar fractures. It can make the compression of spinal cord to be completely and safely relieve d for thoracolumbar fractures with spinal cord injuries, and be used for the recovery of postoperative neurological function. The titanic plate fixation and structural bone graft can recover the stability of injuried spine with excellent bony fusion. ......

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