胸腰椎爆裂骨折前后路手术治疗的疗效比较.docVIP

胸腰椎爆裂骨折前后路手术治疗的疗效比较 　　作者：王泽，欧阳彦成，周谊，甘志勇，朱建军，宋彬，胡豇，黄崇新 作者单位：1.资阳市雁江人民医院骨科，四川 资阳 641300;2.四川省人民医院骨科，四川 成都 610072 　　【摘要】 　　目的 探讨胸腰椎爆裂骨折前后路手术治疗的临床效果。方法 回顾性分析2000年9月至2007年3月，收治平均年龄为31.2 岁的胸腰椎爆裂骨折合并神经损伤44 例，神经功能按Frankel分级评定，A级2 例，B级13 例，C级19 例，D级10 例。根据伤情26 例选择前路手术，18 例选择后路手术。结果 术后伤口均一期愈合，神经损伤症状无加重。44 例获得9～52个月，平均38.8个月随访。除2 例完全性截瘫患者神经功能无变化外，其余病例均有明显恢复，前后路手术Frankel分级分别平均恢复1.8与1.4级。结论 前后路手术各有其特点，前路手术减压更为充分，神经功能恢复较好，融合成功率较高，脊柱序列维持较好。 　　【关键词】 胸腰椎 骨折 前路 后路 手术治疗 　　Comparison between Anterior and Posterior Surgical Treatments of Thoracolumbar Burst Fractures 　　WANG Ze，OUYANG Yancheng，ZHOU Yi，et al 　　(Department of Orthopedics，Yanjiang People′s Hospital of Ziyang City，Ziyang 641300，China) 　　Abstract：Objective To study the clinical outcome of surgical treatments through anterior or posterior approach for thoracolumbar burst fractures.Methods The retrospective review included 44 cases with an average age of 31.2 years from September 2000 to March 2007.The Frankel scale was used for assessment of nerve function.2 cases were rated as Grade A，13 as Grade B，19 as Grade C，and 10 as Grade D before surgery.The surgical approach was chosen according to conditions of the injury.26 cases received anterior approach operation.18 cases received posterior approach operation.Results The mean followup period was 38.8 months.There were no severe postoperative complications，such as deterioration of nerve function.All the cases showed notable improvement except in 2 cases of complete paraplegia，the improvement was 1.8 and 1.4 Frankel grades respectively for the anterior and posterior approach operations.Conclusion The anterior and posterior approaches are different in advantages and characteristics.The surgery through anterior approach provides more decompression good recovery rate of the nerve function，high rate of fusion and better maintenance of sagittal plane alignment. 　　Key words：thoracolumbar vertebra;fracture;anterior approach;posterior approach;surgical treatm