后路椎板开窗减压加对侧椎板植骨融合治疗胸腰椎爆裂性骨折伴不全瘫Posterior laminotomy decompression and bone graft in lamina of vertebra for thoracic and lumbar vertebrae burst fracture with incomplete neurological deficit
胡龙驹;冯新民;陈鹏涛;陶玉平;王永祥;杨建东;李小磊;徐薇;黄成;李艺楠;
摘要(Abstract):
[目的]探讨后路椎板开窗减压加对侧椎板植骨融合治疗胸腰椎爆裂性骨折伴不全瘫的临床疗效。[方法]回顾分析本院从2007年2月~2011年2月收治的48例胸腰椎骨折伴不全瘫的患者,均行后路椎板开窗减压加对侧椎板植骨融合治疗,观察患者疗效。并选择同期分级相似胸腰椎骨折伴不全瘫的患者51例行椎板切除减压作为对照组,将两者出血量、手术时间及术后疗效做一对比。[结果]椎板开窗组术后未出现神经损伤加重及死亡病例。脊柱后凸角度(Cobb角)、伤椎椎体前缘高度、椎管占有率与术前相比,具有统计学意义;患者脊髓及神经损伤ASIA分级术后部分有明显改善;术后1年患者影像学资料显示骨折骨性愈合。无内固定物松动及断裂发生。与椎板切除组相比,椎板开窗组手术时间及手术出血量(术中+术后引流)具有统计学意义。[结论]与后路椎板切除组相比,后路椎板开窗减压加对侧椎板植骨融合治疗胸腰椎爆裂性骨折伴不全瘫具有创伤小、出血少,操作简单、手术时间相对较短,能较大限度保持后结构完整等优势,术中脊髓也能得到有效减压,术后疗效可靠。
关键词(KeyWords): 胸腰椎骨折;椎板开窗;植骨融合
基金项目(Foundation):
作者(Author): 胡龙驹;冯新民;陈鹏涛;陶玉平;王永祥;杨建东;李小磊;徐薇;黄成;李艺楠;
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DOI:
参考文献(References):
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