胸腰椎跳跃型骨折治疗方法的选择及其临床疗效

Treatment options and clinical outcomes of noncontiguous thoracolumber fractures

摘要:

目的 探讨胸腰椎跳跃型骨折治疗方法的选择及其临床疗效。方法 回顾性分析西安交通大学医学院附属红会医院2010 年12 月～ 2014 年1 月共收治的53 例胸腰椎跳跃型骨折患者。根据患者骨折类型及骨密度检测结果分别选择保守治疗、微创经皮内固定、椎体成形、开放复位固定及联合手术等不同方式治疗。总结患者临床资料及术前、术后及末次随访时X 射线及CT 片，对于有神经功能损伤患者, 采用AISA 神经功能分级评价手术前后神经功能状况。结果 所有病例术后均获得12 ～ 24 个月随访，53 例患者伤口均Ｉ期 愈合, 未出现骨折不愈合, 内固定松动断裂情况。合并脊髓损伤者脊髓神经功能有不同程度恢复。结论 对于跳跃性胸腰椎骨折患者, 根据患者伤情及骨密度情况采用个体化方案治疗，可取得满意的治疗效果。

Abstract:

Objective To investigate the treatment and clinical outcomes in noncontiguous thoracolumbar fractures. Methods Fifty-three consecutive cases of noncontiguous thoracolumbar fractures in our hospital from December 2010 to January 2014 were retrospectively investigated, including 19 females and 34 males aged from 18 to 75 years (average 42 years). All patients were treated by conservative treatment or operation according to the type of fracture and bone mineral density (BMD). The clinical data of the patiants and radiographic information before and after operation and at last follow-up were summarized and analysed. ASIA was used to evaluate neurologic disability. Results All patients were followed up for 12-24 months. There was no infection and all incisions got primary healing without fixation failure. All the patients with spinal cord injury had neurological function recovery. Conclusions Application of individualized therapy according to the type of fracture and BMD of the patients can achieve satisfactory result in the treatment of noncontiguous thoracolumbar fractures.