| 经后路椎管前方减压治疗陈旧性胸腰椎骨折截瘫 |
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Received:June 10, 2000 Revised:March 09, 2001
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| 作者 | Author | 单位 | Unit | E-Mail |
| 关凯 |
GUAN Kai |
北京军区总医院,北京100700 |
Beijing General Hospital of PLA,Beijing,100700 |
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| 刘树清 |
LIU Shu qing |
北京军区总医院,北京100700 |
Beijing General Hospital of PLA,Beijing,100700 |
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| 胥少汀 |
XU Shao ding |
北京军区总医院,北京100700 |
Beijing General Hospital of PLA,Beijing,100700 |
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| 刘智 |
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北京军区总医院,北京100700 |
Beijing General Hospital of PLA,Beijing,100700 |
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| 李健民 |
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北京军区总医院,北京100700 |
Beijing General Hospital of PLA,Beijing,100700 |
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| 期刊信息：《中国骨伤》2001年14卷，第11期，第652-655页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨陈旧性胸腰椎骨折截瘫后路椎管前方减压治疗的有效性。
方法：59例陈旧性胸腰椎骨折截瘫病人,平均伤后22个月,42例曾行椎板切除,经后正中入路,经一侧椎弓板内侧至椎体后缘行椎管前方减压,平均随诊14个月(1～8年).
结果：截瘫恢复率72.9%(43/59),不全截瘫中术后Frankel分级提高一级或一级以上为84.4%(38/45);排便功能改善率47%(28/59),椎管扩大率48%.
结论：脊髓前方有压迫的不全截瘫,尤其已行后路手术,留有内固定者,更适用于经后路椎管前方减压。为最大限度减压,椎管一侧压迫为主者,可行单侧椎弓根内侧减压；如椎管前方两侧压迫均重,就行双侧经椎弓根两侧减压术。此方法效果满意,创伤小,出血少。 |
| [关键词]:骨折 胸椎 腰椎 外科手术 截瘫 |
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| Treatment of old thoraco lumbar vertebral fracture with paraplegia with anterior decompression method through posterior approach |
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Abstract:
Objective:To explore clinical effects of anterior decompression method through posterior approach for the treatment of old thoraco lumbar vertebral fracture with paraplegia
Methods:Of 59 patients with old thoraco lumbar vertebral fracture with paraplegia at an average period of 22 months after injury,42 had undergone laminectomy with posterior median approach and anterior decompression through median of unilateral lamina of vertebral arch to posterior border of vertebral body.
Results:The follow up period ranged from 1 to 8 years,with an average of 14 months.The Frankel classification of 84.4% (38/45) of the patients with incomplete paraplegia increased one or more degree after operation.The paraplegia recover ratio was 72.9% (43/59),improvement ratio of defecation function 47% (28/59) and enlargement ratio of vertebral canal 48%.
Conclusion:This operation method is especially suitable for the treatment of incomplete paraplegia patients with anterior compression who had undergone laminectomy and internal fixation.If unilateral compression was serious,decompression operation of unilateral medial pedicle of vertebral arch was performed;and if the compression of both sides were serious,bilateral decompression operation of pedicle of vertebral arch was carried out.This method is of less traumatic and less bleeding and the outcome is satisfactory. |
| KEYWORDS:Fracture Thoracic vertebrae Lumbar vertebrae Surgery operative Paraplegia |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 关凯,刘树清,胥少汀,刘智,李健民.经后路椎管前方减压治疗陈旧性胸腰椎骨折截瘫[J].中国骨伤,2001,14(11):652~655 |
| 英文格式: | GUAN Kai,LIU Shu qing,XU Shao ding.Treatment of old thoraco lumbar vertebral fracture with paraplegia with anterior decompression method through posterior approach[J].zhongguo gu shang / China J Orthop Trauma ,2001,14(11):652~655 |
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