資源描述：
《早期后路手術(shù)治療胸腰椎爆裂性骨折》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、早期后路手術(shù)治療胸腰椎爆裂性骨折劉彬宋留紅劉德祥岳思陽(yáng)(彭州市人民醫(yī)院骨科611930)【摘要】目的探討早期后路手術(shù)對(duì)胸腰椎爆裂性骨折的治療價(jià)值,以達(dá)到最大的椎管后凸骨塊的復(fù)位，恢復(fù)脊椎序列，減少椎管狹窄，增加脊椎的穩(wěn)定性。方法采用后路間接椎管擴(kuò)大、短節(jié)段椎弓根螺釘固定技術(shù)，對(duì)48例(無(wú)神經(jīng)癥狀36例，有神經(jīng)癥狀12例)胸腰椎爆裂性骨折進(jìn)行手術(shù)治療的患者進(jìn)行回顧分析，依據(jù)術(shù)中c臂觀察椎管內(nèi)骨塊復(fù)位情況，決定是否后路椎板減壓。非減壓組40例，減壓組8例，減壓后行橫突間植骨/+單側(cè)椎板后植骨。有神經(jīng)損傷12例,無(wú)神經(jīng)傷36例。結(jié)果48例中無(wú)神經(jīng)
2、損傷36例均未行椎管減壓，椎管侵入(37.16±15.15)%;合并神經(jīng)損傷12例,椎管侵入(48.59±16.89}%,，4例未行椎管減壓,8例行椎管減壓，兩組差異顯著(P<0.05}。非減壓組(40例)和減壓組(8例)術(shù)前侵入椎管比例分別為(41.97±12.90)%、(43.52±16.15)%(P>0.05)o治療后非減壓組和減壓組侵入椎管比例分別為(20.69±15.93)%、(27.37±12.89)%,非減壓組椎管矢狀徑平均改善23
3、.28%,減壓組為14.15%(P<0.05),神經(jīng)損傷癥狀均有明顯改善。結(jié)論胸腰椎爆裂性骨折引起的椎管狹窄程度與祌經(jīng)損傷密切相關(guān)，術(shù)中根據(jù)c臂觀察椎管內(nèi)骨塊后凸復(fù)位情況決定是否行椎管減壓，早期后路手術(shù)能大部分改善胸腰椎爆裂性骨折椎管狹窄程度，多數(shù)不需要后路減壓，減少對(duì)脊椎后柱的破壞。【關(guān)鍵詞】胸腰椎爆裂性骨折手術(shù)治療【中圖分類號(hào)】R687【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】2095-1752(2013)33-0109-03[Abstract]Objective：Toexplorethetherapeuticvalueofposterioro
4、perationearlyburstfracturesofthoracolumbar,reductiontoachievemaximumcanalskeletonblock,restorevertebralsequence,reducespinalstenosis,increasethestabilityofspine.Methods:usingindirectspinalcanal,posteriorshort-segmentpediclescrewfixation,48cases(36caseswithoutneurologicalsy
5、mptoms,neurologicalsymptomsin12cases)ofthoracolumbarburstfractureswereretrospectivelyanalyzedpatientsunderwentoperationtreatment,basedontheintraspinalbonereductionwereobservedinCarm,decidewhetherposteriordecompression.Nondecompressiongroup40cases,decompressiongroup8cases,b
6、onegraftafterdecompressionintertransverse/+afterlaminectomy.Thereare12casesofnerveinjury,nonerveinjuryin36cases.Results:therewasnonerveinjuryin36caseswerenotdecompressionofspinalcanalin48cases,invasive(37.16±15.15)%;12casescomplicatedwithnerveinjury,spinalcanalintru
7、sion(48.59±16.89)%”4caseswithoutspinalcanaldecompression,8casesofspinalcanaldecompression,twogroupshadsignificantdifference(P<0.05).Nondecompressiongroup(40cases)anddecompressiongroup(8cases)preoperativevertebralcanalrespectively(41.97±12.90)%,(43.52&plusm
8、n;16.15)%(P>0.05).Afterthetreatmentofnondecompressionofvertebralcanaldecompressiongrou
