中国骨伤2012，Vol.25Issue(10)：834-837,4.DOI:10.3969/j.issn.1003-0034.2012.10.012
经椎旁肌间隙入路短节段结合伤椎固定治疗胸腰椎骨折
Surgical treatment of thoracolumbar fractures using reduction and short-segment pedicle screw at the fracture level with the approach through para-vertebral muscles
董伊隆 1彭茂秀 1黄益奖 1林利兴 1汤呈宣 1杨国敬1
作者信息
- 1. 温州医学院附属第三医院骨科,浙江瑞安 325200
- 折叠
摘要
Abstract
Objective:To evaluate the efficacy and clinical outcome of reduction and pedicle screws fixation at the fracture level with the approach through para-vertebral muscles in treating thoraeolumbar fractures. Methods: From January 2007 to March 2010,27 patients with thoracolumbar fractures were treated with posterior open reduction and internal fixation with the approach through para-vertebial muscles. There were 19 males and 8 females with the mean age of 36.3 years old (ranged,21 to 57). According to Magerl type,type A2 was in 5 cases,A3 in 14,Bl in 3,B2 in 5. According to Frankel classification of spinal cord injury: grade D was in 6 cases and grade E in 21 cases. X-rays and CT scans were performed after operation. Cobb angle of the injured vertebral segment,the percentage of vertebral compression,and sagittal diameter stenosis rate of the injured spinal canal were observed by radiographic data. Neurological function was evaluated by the Frankel grade. Results:All patients were followed up from 12 to 28 months with an average of 19.6 months. The percentage of vertebral compression,Cobb angle of the injured vertebral segment,spinal canal sagittal diameter stenosis rate were respectively corrected from (46.6±10.5)%, (18.3±7.2)°, (30.2±7.2)% to postoperative(5.2±3.7)%, (5.3±5.1) °,(6.3±4.2)% and(6.7±4.6)%, (7.1±3.1) °,(7.2±4.5)% at last follow-up. There were significant difference in above items between preop-eration and postoperation (P<0.05); and there was no significant difference in above items between postoperation and last follow-up (P>0.05). In aspect of nerve function,3 cases with Frankel grade D recovered to grade E. Conclusion:Using reduction and short-segment pedicle screws fixation at the fracture level through para-vertebral muscles approach is an effective method in treating thoracolumbar fractures. The method has advantages of simple operation,easy establishing screw, short operative time,less blood loss,which can obtain good reduction and stable,reliable fixation after operation.关键词
胸椎/腰椎/脊柱骨折/外科手术Key words
Thoracic vertebrae/ Lumbar vertebrae/ Spinal fractures/ Surgical procedures, operative引用本文复制引用
董伊隆,彭茂秀,黄益奖,林利兴,汤呈宣,杨国敬..经椎旁肌间隙入路短节段结合伤椎固定治疗胸腰椎骨折[J].中国骨伤,2012,25(10):834-837,4.
