【摘要】 目的对比前后路手术治疗胸腰椎爆裂性骨折合并脊髓损伤的疗效。方法 2010-01—2012-12收治49例胸腰椎爆裂性骨折患者分为A组23例和B组26例。A组行前入路锥体次全切除,钛网重建内固定手术;B组行后入路椎体次全切除,钛网重建内固定术。对比2组治疗效果。结果 2组术中出血量、手术时间、术后神经功能比较差异无统计学意义(P>0.05);而术后VAS评分B组优于A组(P<0.05);A组末次随访(术后9个月)时Cobb角恢复优于B组(P<0.05);2组均无严重并发症。结论前后路手术治疗胸腰椎爆裂性骨折合并脊髓神经损伤疗效相当,根据患者的个体情况,合理选择手术入路,有助于提高临床疗效。更多还原

【Abstract】 Objective To observe the results of posterior and anterior reconstructions with subtotal vertebrectomy,decompression and internal fixation for severe thoracolumbar veterbrae burst fractures.Methods 49 patients of thoracolumbar veterbra burst fractures from Jan 2010 to Dec 2012 were divided into A group(23patients)and B group(26patients).A group received posterior approach for spine reconstruction with subtotal vertebrectomy decompression and internal fixation and B group received anterior approach for spine reconstruction with subtotal vertebrectomy decompression and internal fixation.The clinical effects of the two groups were compared.Results There was not significantly different between the two groups in intraoperative blood loss,operation time,ASIA scores,the heights of anterior edge of vertebral body(P>0.05);At post-operation,the VAS score of B group was signifieantly lower than that of A group.Conclusion The posterior surgical treatment of thoracolumbar burst fracture complicated with spinal cord injury shows equivalent clinical effects with the anterior surgery,both kinds of surgery can restore vertebrae height,correct local kyphosis and improve nerve function.更多还原