【摘要】 [目的]探讨侧前方钉板内固定系统治疗胸腰椎骨折的围手术期处理方法。[方法]根据胸腰段侧前方钉板内固定系统的内固定原理及植入要求在30例胸腰段椎骨标本上标出进钉点、进钉方向,并测量、观察其与周围易识别骨性标志的关系,为手术中测量、判断进钉点、进钉方向提供参考;根据60例胸腰椎骨折患者术前X线片及CT片,结合理论进钉点、进钉方向及内固定要求推算出螺钉、钢板长度、撑开高度及植骨块长度等指标的理论值作为术中使用的参考值,并在术中利用易识别骨性标志测量、判断进钉点、进钉方向;根据术中测量及术中或术后X线片评价进钉点、进钉方向、螺钉、钢板长度、撑开高度及植骨块长度等理论指标的准确性。[结果]术中测量、判断进钉点、进钉方向容易、准确、可靠;术前测量指标与术中、术后测量指标基本一致;60例患者术后脊柱结构、功能恢复良好,手术疗效满意。[结论]该围手术期处理方法科学、实用,对保证胸腰段侧前方钉板内固定系统成功植入,并减少手术并发症有较强的指导意义。更多还原

【Abstract】 [Objective]To discuss the perioperative management of thoracolumbar fractures fixed with latero-anterior screw-plate system.[Method]The entry point and direction of screw on 30 thoracic and lumbar vertebra specimens were marked based on the principle and demand of implantation of latero-anterior screw-plate system and were determined exactly by anatomic landmarks in order to make reference for operation.Sixty patients with thoracolumbar fractures were treated with anterior decompression,bone grafting and internal fixation from January 2000 to June 2007.Reference data such as the length of vertebral body screw and plate and the height of bracing gotten from the patients’X-ray and CT findings before operation were compared with practical data measured during operation.The entry point and the direction of screw were determined exactly by anatomic landmarks of thoraco lumbar vertebrae and were checked by X-ray during operation.[Result]The judgement of the entry point and the direction of screw was easy and accurate during operation and the reference data were in coincidence with practical data.The effects of operation were satisfactory.[Conclusion]The perioperative management is both scientific and practical.The surgical complications can be reduced in this way.更多还原