胸腰段爆裂骨折经后路间接减压的影像学观察

目的本文旨在探讨后路间接减压治疗胸腰段爆裂骨折对椎管减压的效果。方法选择2005年1月-2006年12月,胸腰段爆裂骨折应用后路撑开复位间接减压治疗45例,从影像学方面分析疗效。观察指标为手术前后的伤椎前后缘高度,腰椎后凸畸形(Cobb's角),椎管的正中矢状径的变化。并应用统计学分析。结果伤椎前缘高度由术前51%恢复到术后92%;伤椎后缘高度由术前56%恢复到术后93%;Cobb's角由术前28.6恢复到术后5.8。椎管受压程度,删除椎管开放减压4例,余受压的椎管正中矢状径由术前58%恢复到89%。结论合理选择适应证,后路撑开复位间接减压治疗胸腰段爆裂骨折对椎管减压的疗效满意,术中C臂透视分析影像学椎体后缘骨块形态有助于提高椎管减压效果。

Studed by X-ray images of thoracolumlor burst fracture in treatment with indirect decompression to vertebral cannal

Objective To investigate clinical effect of Indirect decompression to vertebral cannal for treatment of thoracolumbar vertebral burst fractures treated with posterior approach and pedicle screw fixaion. Methods 45 cases with thoracolumlor burst fractures were treated in our hospital from January 2005 to December 2006. The effect was studied by X-ray images. The date were compared statistically. Results According to X-ray and CT checking. The Cobb's angle was revised from averaged 28.60 preoperatively to averaged 5.8 postoperatively. Anterior height of compressed vertebral bodies was restored from 51% preoperatively to 92% postoperatively;posterior height was from 58% to 93%;The sagittal spinal cannal occulusion-median diameter value was from58% to 89% except for direct decompression 4 cases. Conclusion Reasonable election of posterior approach and for thoracolumlor burst fracture can provide good effect of indirect decompression to vertebral cannal,and it can entrance reduction by analysizing fracture mass of posterior vertebral wall intraoperation.