中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (5): 581-583.doi: 10.13418/j.issn.1001-165x.2016.05.021

• 临床研究 • 上一篇    下一篇

椎板开窗减压结合肌间隙入路置钉治疗伴神经损伤胸腰椎爆裂骨折

陈子华,    刘丹, 陈鑫营, 陈建威, 曾红生, 方磊, 游军   

  1. 暨南大学附属河源医院(河源市人民医院)脊柱外科,  广东   河源    517000
  • 收稿日期:2016-04-11 出版日期:2016-09-25 发布日期:2016-10-14
  • 作者简介:陈子华(1967-), 男,江西抚州人,主任医师,主要从事脊椎外科临床工作,Tel:07623185856,E-mail:czh184@163.com

Minimally invasive fenestration canal decompression and gap muscle pedicle screw fixation for thoracolumbar burst fractures with neurologic injury

CHEN Zi-hua, LIU Dan, CHEN Xin-ying, CHEN Jian-wei, ZENG Hong-sheng, FANG Lei, YOU Jun   

  1. Department of Orthopedics, Heyuan Hospital Affiliated to Jinan University,Guangdong Heyuan 517000,China
  • Received:2016-04-11 Online:2016-09-25 Published:2016-10-14

摘要:

目的 探讨小切口椎板开窗行椎管减压,结合椎旁肌间隙入路置钉治疗伴神经损伤胸腰椎爆裂骨折手术疗效。   方法 回顾研究自2013年1月至2016年2月采用小切口椎板开窗椎管减压+椎旁肌间置钉内固定治疗33例合并神经损伤的胸腰椎爆裂骨折。   结果    33例获得2~36个月随访,平均17个月,手术时间短,术中及术后出血量少,腰背部疼痛均优于传统后正中手术,术后椎体高度、Cobb角矫正率、椎管狭窄及神经功能情况,均有不同程度恢复。   结论 小切口椎板开窗减压+肌间隙置钉治疗合并神经损伤胸腰椎爆裂骨折与传统后正中手术具有相同疗效,具有手术时间短,创伤小,出血量少,术后患者恢复快,保留了脊柱结构和稳定性,而且可以使椎管得到有效减压。

关键词: 胸腰椎, 骨折, 神经损伤, 开窗, 椎旁肌间隙入路

Abstract:

Objective To explore the efficacy of minimally invasive fenestration canal decompression and gap muscle pedicle screw fixation for the treatment of thoracolumbar burst fractures with neurologic injury. Methods From January 2013 to February 2016, 33 cases of thoracolumbar burst fractures with neurologic injury were treated with minimally invasive fenestration canal decompression and gap muscle pedicle screw fixation. Result 33 patients were followed up for 2-36 months,with an average of 17 months. Compared with the conventional surgical approach, shorter operative time,less intraoperative and postoperative bleeding,milder back pain were resulted using the surgical approach described in this paper.There were varying degree of recovery of vertebral height,,Cobb angle correction rate,spinal stenosis and neurological conditions. Conclusion Minimally invasive fenestration canal decompression and gap muscle pedicle screw fixation for treatment of thoracolumbar burst fractures with neurologic injuryhas the advantages of enjoying a shorter operative time,less trauma,less bleeding,rapid postoperative recovery,as well as retaining the structure and stability of the spine, resulting in effective reduction of pressure within the spinal canal.

Key words: Thoracolumbar fractures, Nerve injury, Fenestration, Paraspinal muscle approach