摘要
目的比较前路减压内固定与后路椎体截骨治疗陈旧性胸腰椎骨折的疗效。方法39例伴有神经受损和后凸畸形胸腰椎骨折的患者,采用前路固定19例,后路椎体截骨20例。前路固定组:平均年龄38.3岁(21～64岁),受伤至手术时间平均5.3个月(2～16个月),术前后凸角平均25.2°(10°～43°)。后路椎体截骨组:平均年龄39.9岁(18～68岁),受伤至手术时间平均5.6年(2个月～16年),术前后凸角平均27.6°(5°～60°)。结果前路固定组:平均手术时间为274min(140～395min),平均出血为994mL(300～2000mL),术后平均后凸角为14.7°(0～35°),平均矫正10.5°(5°～16°)。后路椎体截骨组:平均手术时间为283min(190～3950min),平均出血为1654mL(800～3800mL),术后平均后凸角为4.4°(-10°～30°),平均矫正23.2°(7°～40°)。所有的不完全神经损伤的患者神经功能都得到改善。结论后路椎体截骨在不增加手术创伤的同时,可以获得更好的后凸矫正。
Objective To compare the surgical results between anterior fixation and posterior vertebral osteotomy in patients with old thoracolumbar fracture. Methods 39 cases of old thoracolumbar fracture with posttraumatic kyphosis and neurologic compromise underwent either anterior fixation (n=19) or posterior vertebral osteotomy(n=20). In the anterior group, the average patient age was 38.3 years (range:21 to 64), the mean time from injury to operation was 5.3 months (range:2 to 16), and the mean preoperative kyphotic angle was 25.2°(range:10°to 43°). In the posterior group, the average patient age was 39.9 years (range:18 to 68), the mean time from injury to operation was 5.6 years (range: 2months to 16 years), and the mean preoperative kyphotic angle was 27.6°(range:5°to 60°). Results In the anterior group, the mean operation time was 274 minutes (range:140 to 395) with a mean blood loss of 994 mL (range: 300 to 2000), the mean postoperative kyphotic angle was 14.7°(range: 0°to 35°), and the mean angle of correction was 10.5 °(range: 5°to 16°). In the posterior group, the mean operation time was 283 minutes (range:190 to 390) with a mean blood loss of 1654 mL (range: 800 to 3800), the mean postoperative kyphotic angle was 4.4°(range:-10°to 35°), and the mean angle of correction was 23.2°(range: 7°to 40°). All the patients with incomplete neural injury had improvement of neurologic function. Conclusion The posterior vertebral osteotomy can produce better results in kyphotic correction, while it does not increase the trauma of operation.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第11期1223-1225,共3页
Chinese Journal of Orthopaedic Trauma
关键词
胸腰椎
骨折
截骨术
骨折固定术
内
Thoracolumbar spine
Fracture
Osteotomy
Fracture fixation, internal
