一期前后入路治疗胸腰椎严重爆裂性骨折临床效果研究

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1、一期前后入路治疗胸腰椎严重爆裂性骨折临床效果研究　　[摘要]目的探讨一期前后联合入路治疗胸腰椎严重爆裂性骨折合并脊髓及神经损伤患者的临床疗效。方法2008年2月～2012年1月本院骨科行一期前后入路手术治疗胸腰椎严重爆裂性骨折合并脊髓及神经损伤患者共18例，分析一期前后联合入路的优缺点、适应证和临床效果。结果本组患者椎管均获得有效减压，平均随访（13.6±3.6）个月，植骨块融合良好，伤椎高度基本恢复。Cobb角由术前平均18°恢复到3°。Flankel分级恢复1级者7例，2级者6例，无变化者5例。结论

2、一期前后联合入路手术是治疗胸腰椎严重爆裂性骨折合并脊髓及神经损伤的有效方式，是集减压、复位内固定、植骨融合一次完成的有效方法，但手术创伤较大，应严格掌握手术适应证。[关键词]一期前后联合入路；胸腰椎；严重爆裂骨折；减压；内固定[中图分类号]R683[文献标识码]B[文章编号]1674-4721（2013）06（c）-0178-02Clinicaleffectanalysisofonestageanterior-posteriorapproachinthetreatmentofsevereburstfra

3、ctureofthoracolumbarspine8PANWeiwenDAIGuolianFANNifangLIYupingWANGHongxinOrthopaedicsDepartmentofGaobuHospitalinDongguanCity，GuangdongProvince，Dongguan523270，China[Abstract]ObjectiveToexploretheclinicaleffectsofonestageanterior-posteriorapproachinthetrea

4、tmentofsevereburstfractureofthoracolumbarspinecombiningwithnerveinjury.MethodsEighteenpatientssufferedfromsevereburstfracturesofthoracolumbarspinewithnerveinjuriesunderwentonestageanterior-posteriorapproachinourorthopedicsdepartmentfromFebruary2008toJanu

5、ary2012.Theadvantagesanddisadvantages，indications，andclinicaleffectsofonestagecombinedanteriorandposteriorapproachwereanalyzed.ResultsTheeffectivedecompressionsofspinalcanalinallpatientswereobtained.Anaverageof（13.6±3.6）monthsfollow-upvisits，thebonegraft

6、fusionwasgood，andtheinjuredvertebraheightbasicallyrecovered.TheCobbanglerecoveredfromaverage818°pre-operationto3°.AccordingtoFlankelgradingrecovery，therewere7casesingradeⅠ，6casesingradeⅡ，and5caseswithoutchanges.ConclusionOnestagecombinedanteriorwithposte

7、riorapproachisaneffectivewaytotreatsevereburstfractureofthoracolumarspinecombiningwithspinalcordinjuryandnerveinjury，whichaccomplishesthedecompression，reductionandinternalfixation，andbonegraftfusionforonce.Whereas，theoperativewoundismuchbigger，thesurgica

8、lindicationsshouldbeproficientlymastered.[Keywords]Onestagecombinedanteriorwithposteriorapproach；Thoracolumbarspine；Severeburstfracture；Decompression；Internalfixation8脊柱胸腰椎严重爆裂性骨折常因伤椎后缘骨块后移压迫脊髓或马尾而致神经功能障碍，是骨科临床上比较常见的脊柱损伤[1