【摘要】 目的探讨胸腰椎骨折经前路椎管减压与脊柱稳定性重建的手术要点与经验。方法回顾我院33例胸腰椎骨折经前路减压、植骨融合内固定手术病例,从椎管减压、脊柱稳定性重建方法及效果方面,总结前路手术经验。结果 33例均获得随访,随访时间9～48个月(平均26个月),显示手术后胸腰椎生理曲度恢复满意,平均Cobb角及平均椎管狭窄指数得到明显改善(P<0.05),神经功能恢复(ASIA分级)提高1～2级。术中无较大副损伤出现,术后未发生断棒脱钉等并发症。结论前路减压彻底,重建方式符合脊柱生物力学分布原则,远期脊髓神经再压迫风险小。更多还原

【Abstract】 Objective To summarize the surgical precautions and experience of anterior spinal decompression and spinal reconstruction for thoracolumbar fracture.Methods Thirty-three patients undergoing anterior decompression and bone graft fusion with internal fixation were retrospectively reviewed.The methods and outcomes of spinal decompression and reconstruction were examined.Results Thirty-three patients were successfully followed up for 9-48 months(mena,26 mo),showing a favorable postoperative physiological thoracolumbar curve.The mean Cobb′s angel and spinal stenosis index improved significantly(P<0.05).Nervous function(ASIA) was improved 1-2 grade.No major iatrogenic injuries occurred intraoperatively whilst no rod break or screw shift was observed postoperatively.Conclusion The anterior approach allows a complete decompression and the reconstruction favors the spinal biomechanics,with a low risk of long-term recurrent spinal decompression.更多还原