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
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (5) : 581-583.
Minimally invasive fenestration canal decompression and gap muscle pedicle screw fixation for thoracolumbar burst fractures with neurologic injury
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.
Thoracolumbar fractures / Nerve injury / Fenestration / Paraspinal muscle approach
[1] 周方. 脊柱及四肢骨折的治疗决策[M].北京:北京大学医学出版社,2010:44-51.
[2] 范顺武,胡志军,方向前. 腰椎后路中脊旁肌保护的相关思考[J].中华骨科杂志,2011, 31(4):400-407.
[3] 王世栋,邓雪飞,尹宗生,等. 腰椎后路椎旁肌间隙入路的解剖学与影像学观察[J].中国脊柱脊髓杂志,2013, 23(3):257-262.
[4] Wiltse LL,Bateman JG,Hutchinson RH,et al The parespinal sacropinalis-splitting approach to the lumbar spine [J].J Bone Toint Surg Am,1968, 50(5):919-926.
[5] 赵斌,赵轶波,马迅,等. 经椎旁肌间隙入路在胸腰椎骨折治疗中的应用[J].中华骨科杂志,2011, 31(10):1147-1151.
[6] 林野,吴丹凯,朱庆三,等. 胸腰椎爆裂骨折椎管内骨块复位生物力学与解剖学研究[J].中国临床解剖学杂志,2004, 22(1):89-91.
[7] 王伟,任龙喜.保留后方韧带复合体椎管隧道式减压治疗胸腰椎骨折[J].中国脊柱脊髓杂志,2006, 16(1):75-76.
[8] 李海峰,顾三军,孙振中, 等. 椎板开窗椎管减压治疗伴神经损伤胸腰椎爆裂骨折[J]. 中国骨与关节损伤杂志,2016, 31(1):30-32.
[9] Degreif J,Wenda K,Runkel M, et al. Rotational stability of the thoracolumber spine after interlaminar ultrasound window,hemilaminectomy and laminectomy A comparative experimental study[J].Vnfallchirurg,1994, 97(5):250-255.
[10] 陈子华,陈建威,陈鑫营,等. 经伤椎植骨短节段固定非融合治疗胸腰椎爆裂骨折疗效分析[J].中国临床解剖学杂志,2014, 32(5):613-615.
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