【摘要】 目的　探讨胸膜外前路减压与重建手术治疗胸腰椎骨折合并脊髓损伤的临床效果。方法　自 1996年 2月~2002年 12月对 62例胸腰椎骨折合并脊髓损伤患者行胸膜外前路减压与重建手术。结果 所有病例术后均获得1. 5~8年的随访, 46例椎体近解剖复位, 16例复位良好。无感染、无胸膜粘连和断钉等并发症,全部椎体间骨性融合。神经功能恢复:除 6例A级及 2例D级无变化外,其余均有 1~2级恢复。矢状面Cobb角术前平均 28. 4°,术后平均为 14. 3°。椎体前缘高度术前平均为椎体的 41. 3%,术后平均 92. 4%。结论 胸膜外前路减压与重建手术可解除脊髓的压迫、改善脊髓神经功能、恢复脊柱的序列及重建脊柱的稳定性,且减少胸腔的并发症。更多还原

【Abstract】 Objective To discuss the clinical effect of extrapleural anterior decompression and reconstruction on the surgical treatment of thoracolumbar fractures with spinal cord injuries. Methods Sixty-two cases of thoracolumbar fractures with spinal cord injuries were treated by extrapleural anterior decompression and reconstruction from February 1996 to December 2002. Results All the cases were taken a follow-up for 1.5-8 years. Forty-six cases were reconstructed almost on anatomy and 16 cases were well reconstructed. No complication such as infection, pleural adhesions or screw broken and so on occurred, and all the vertebral bodies got bony confluence. All got one-or-two-grade recovery of neurological function except 8 cases without any changes,6 in A grade and 2 in D. The mean Cobb angle in the sagittal plane was 28.4° before operation and 14.3° after operation. The mean height of anterior border of vertebral body was 41.3% of vertebral body before operation and 92.4% after operation. Conclusion Extrapleural anterior decompression and reconstruction could relieve the compression on spinal cord, improve the function of spinal nerves, recover the sequence of spine and reconstruct the stability of spine, and decrease the complications of thoracic cavity.更多还原