节点文献

后路椎体次全切加椎间植骨融合治疗22例胸腰段骨折脱位的疗效观察

Clinical effect of posterior approach for spine reconstruction with subtotal vertebrectomy for thoracolumbar vertebra burst fracture in 22 cases

  • 推荐 CAJ下载
  • PDF下载
  • 不支持迅雷等下载工具,请取消加速工具后下载。

【作者】 刘登均李克俭贺小兵王明贵殷浩王海李争艳

【Author】 LIU Deng-jun;LI Ke-jian;HE Xiao-bing;WANG Ming-gui;YIN Hao;WANG Hai;LI Zheng-yan;Department of Orthopedics,Chongqing Fuling Central Hospital;Department of ICU,Chongqing Fuling Central Hospital;

【机构】 重庆市涪陵中心医院骨科重庆市涪陵中心医院重症医学科

【摘要】 目的探讨一期经后路复位、椎体次全切加椎间支撑植骨术治疗胸腰段骨折脱位的疗效。方法2012年1月~2014年12月重庆市涪陵中心医院骨科采用后路椎体次全切加椎间植骨融合治疗胸腰段骨折脱位共22例,男性15例,女性7例;年龄22~53岁,平均38.3岁。比较术前、术后后凸Cobb角,测量椎管容积率、伤椎高度以及随访神经功能分级变化。结果所有手术切口均甲级愈合。手术时间180~300min,术中出血量800~2800m L。22例均获随访,随访时间6~22个月,平均12个月。植骨均骨性愈合,愈合时间6~9个月,平均7个月,所有病例无内固定松动、断裂;椎体高度、曲度和椎管容积无明显丢失。末次随访时Frankel神经功能分级均较术前恢复明显,Cobb角:术前(24.2±2.8)°,术后6个月为(5.8±0.6)°,P<0.01。椎管容积率:术前(47.05±5.47)%,术后6个月为(98.23±0.98)%,P<0.01。结论经后路复位椎体次全切除可以很好恢复椎管容积及Cobb角,有利于脊髓神经功能恢复。椎间支撑植骨融合,脊柱稳定性好,骨性融合率高,虽然术中出血相对较多,对术者技术要求较高,但目前是治疗胸腰段骨折脱位一种安全、有效的手术方法。

【Abstract】 Objective To evaluate the early clinical outcomes of subtotal corpectomy and intervertebral bone grafting via posterior approach in the treatment of thoracolumbar burst fracture and dislocation. Methods Between Jan. 2012 and Dec. 2014,22 patients with thoracolumbar burst fracture and dislocation were treated with subtotal corpectomy and intervertebral bone grafting via posterior approach. Among them 15 were males and 7 were females with an average of 38. 3( 22-53) years. The Cobb’s angle,vertebral canal volume,intervertebral height before and after surgery and spinal nerve function recovery of all patients were observed. Results All incisions healed well. The operative time was 180-300 min and the hemorrhage volume was 800-2800 m L. The follow-up period was6-22 months( average,12 months). The bone grafting healed during 6-9( average,7) months. There was no serious complication related to internal fixation,and recovered vertebral body height was achieved in all cases. No internal fixation loosening or breakage occurred. No vertebral height,curve or volume was lost. During the last follow-up,Frankel nerve function recovery was good. The Cobb’s angle was rectified from( 24. 2 ± 2. 8) °preoperatively to [( 5. 8± 0. 6) °,P < 0. 01] postoperatively,and the spinal canal volume increased from( 47. 05 ± 5. 47) % preoperatively to( 98. 09 ±0. 98) %( P <0. 01) postoperatively. Conclusion Posterior approach for spine reconstruction with subtotal vertebrectomy,decompression and internal fixation is an excellent method for thoracolumbar vertebra burst fractures and good for the recovery of canal volume and Cobb angle and spinal cord function. Though this surgical technique has a relatively large amount of blood loss and high requirements for surgeons,it is a safe and effective method.

  • 【文献出处】 创伤外科杂志 ,Journal of Traumatic Surgery , 编辑部邮箱 ,2017年03期
  • 【分类号】R687.3
  • 【被引频次】2
  • 【下载频次】28
节点文献中: 

本文链接的文献网络图示:

本文的引文网络