摘要
近年来胸腰椎骨折的手术治疗已经获得长足进步,胸腰椎损伤分类及严重度评分(TLICS)、新AO分型作为临床应用最广的分型评分,对临床治疗和科研有明确的指导意义。随着CT、MRI的广泛应用,评分系统中涉及对后方韧带复合体(PLC)损伤诊断的分歧进一步缩小。随着椎弓根螺钉的广泛应用及对脊柱解剖、力学特点的深入认识,手术固定方式正逐步发展为后路椎弓根螺钉固定为主,前路固定或前后路固定仅在特殊情况下使用。由于对椎弓根螺钉力学研究的深入,伤椎固定越来越受到重视,加上脊柱矢状面平衡的深入研究,伤椎重建作为一个新的概念被提出,并得到进一步研究。笔者就胸腰椎骨折评分系统、手术入路、手术固定节段、伤椎植骨重建及微创治疗等进行探讨,供同道参考并指正。
In recent years, the surgical treatment of thoracolumbar fractures has made great progress. The thoracolumbar injury classification and severity score (TLICS) of thoracolumbar injuries and the new AO classification, as the most widely used classification score in clinical application, have a clear guiding significance for clinical treatment and scientific research. With the extensive application of CT and MRI, the divergence in the diagnosis of posterior ligament complex (PLC) injury in scoring systems has been narrowed. With the wide application of pedicle screw and the deeper understanding of the anatomical and mechanical characteristics of spine, posterior pedicle screw fixation has been gradually adopted as the major method, while anterior or posterior pedicle screw fixation is only used in special cases. Because of the in-depth study of pedicle screw mechanics, more and more attention has been paid to the fixation of injured vertebrae. Moreover, with the intensive study of sagittal balance of the spine, the reconstruction of injured vertebrae has been proposed as a new concept and further investigated. The author discusses thoracolumbar fracture scoring system, surgical approach, surgical fixation segment, bone graft reconstruction and minimally invasive treatment so as to provide some reference.
作者
徐荣明
吕亮
Xu Rongming;Lyu Liang(Orthopedic Center of Mingzhou Hospital,Zhejiang University,Ningbo 315000,China;Emergency Medical Center,Second Hospital of Ningbo Yinzhou,Ningbo 315000,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2019年第1期2-5,共4页
Chinese Journal of Trauma
关键词
脊柱骨折
胸椎
腰椎
Spinal fractures
Thoracic vertebrae
Lumbar vertebrae
作者简介
通信作者:徐荣明,Email:xu_rj@21cn.com,电话:13957894218.
