【摘要】 目的　探讨胸腰椎骨折前路减压固定术并发症产生原因和处理对策。　方法　1998年 2月-2004年 8月,收治胸腰椎骨折伴截瘫采用前路减压固定术者 204例,近期并发症 34例 51例次,发生率为 25. 0%。测量术前、术后及随访时的胸腰椎正侧位X线片,随访神经功能康复状况。　结果　术后发生感染 1例;脑脊液漏 7例;气胸 8例;血气胸 2例;肋间神经损伤 5例;腰神经根损伤 2例;脊髓损伤加重 2例;生殖股神经损伤 3例;股外侧皮神经损伤 2例;术侧肢体皮温升高 8例;深静脉血栓形成 3例。术后半个月内复查X线片示:脊柱侧凸畸形 3例,后凸畸形 5例,占 4. 0%。84例获得随访,时间 3个月~6年,平均 2. 5年。其中慢性腰背痛 7例,脊柱后凸畸形 6例,侧凸畸形 5例。无断钉、断棒、内固定松动、假关节形成等并发症。　结论　熟练掌握胸腰椎前路减压操作技术、减轻术中创伤、恰当合理的康复指导,可避免大多数并发症。更多还原

【Abstract】 Objective To discuss causation and clinical treatment of complication in anterior decompression and fixation technique (ADFT) for thoracolumbar fractures with associated paraplegia. Methods A total of 204 cases that had thoracolumbar fractures with paraplegia were operated with ADFT from 1998 to 2004. Of all, 51 times (34 cases) of complication took place. Change of Cob angle was measured according to X-film of thoracolumbar spine before and after operation. Meanwhile, sensation and motion of patients was evaluated. Results There was incision infection leading to septic cerebo-meningtis in one case, CSF leakage in seven, pneumothorax in eight, rib nerve-root injure in five, lumbar nerve-root injure in two, genitofemoral nerve injure in three, lateral femoral cutaneous nerve injure in two, kyphosis in three, deep venous thrombosis in three and eight times of skin-temperature change. X-film that was taken after operation for all patients showed scolisis in five cases. A follow up for 3-6 years (average 2.5 years) was performed in 84 cases, of which seven cases had chronic low-back pain, six scolisis and five kyphosis. No patient showed complications such as screw breakage, plate breakage, fixation device loosening and pseudo-articulation in thoracolumbar spine. Conclusions Many complications can be avoided if we master well anterior decompression and fixation technique of thoracolumbar fracture, reduce surgical trauma and give appropriate and rational guide for rehabilitation.更多还原