成人下腰椎骨折合并马尾神经损伤的手术治疗

目的探讨成人下腰椎骨折合并马尾神经损伤的手术治疗方法及疗效。方法回顾性分析2004年1月—2010年10月在我科进行手术治疗并随访1.5年以上的34例下腰椎骨折合并马尾神经损伤患者,比较手术前后影像学资料、ASIA功能评分等指标。结果术后随访1.5年以上,ASIA神经损伤评分明显改善,无加重病例发生,术后X线示:脊柱后凸畸形矫正,椎体高度恢复至正常椎体高度80%～95%,磁共振(MR)检查:椎管无明显狭窄,伤椎局部硬膜囊无明显致压物存在。结论椎体爆裂骨折伴马尾神经损伤的患者,通过早期行后路椎板减压、马尾神经回纳、硬膜修补、椎弓根钉内固定植骨融合可取得较好疗效。

Surgical treatment of lumbar fractures combined with cauda equina injury in adults

Objective To explore the surgical treatment of adult lumbar fracture combined with cauda equina injury and its efficacy.Methods A total of 34 patients with lower vertebral fracture plus cauda equina injury,who underwent surgical treatment in our hospital from January 2004 to October 2010 were retrospectively analyzed.Results According to the follow-up of 1.5 years,the patients were significantly improved in ASIA nerve injury score,without any aggravation.Postoperative X-ray showed that kyphosis was corrected,and that vertebral height restored to 80% to 95%.MRI showed that neither spinal stenosis occurred nor local dural sac pressure from the fractured vertebral body existed.Conclusion The surgical treatment for the patients with vertebral burst fractures plus cauda equina injury is effective.