摘要
胸腰椎爆裂骨折占胸腰椎骨折的50%以上,其经常导致神经损伤和脊柱后凸畸形,对于每一种类型的骨折其治疗方法各不相同,目前应用于临床的方法有保守疗法、前路手术、后路手术、前后路联合手术及微创手术,然而最佳的治疗方法仍然是不明确的,没有一种精确的分型来指导爆裂骨折的治疗及手术方式的选择。文章综述了胸腰椎爆裂骨折的治疗进展。有研究表明无神经损伤的稳定型爆裂骨折保守治疗和手术治疗并无明显差别。伴有神经损伤的不稳定型爆裂骨折早期手术减压和稳定是应当考虑的,有研究表明对于短节段固定联合各种不同方式的椎体成形术重建前柱可以明显减少内固定失败及远期脊柱后凸畸形的发生率而受到广大脊柱外科医生的推崇。按照生物力学原理及考虑到患者固定节段后相邻节段退变的发生,非融合技术已逐渐应用于临床,其远期疗效尚需进一步研究证实。
Thoracolumbar burst fractures account for more than half of all thoracolumbar fractures,which often result in neurologic deficit, kyphosis deformity and significant disability. The management of thoracolumbar burst fractures differ with the types. Nowadays,the accepted methods of treatment of thoracolumbar burst fractures include conservative therapy,posterior reduction and instrumentation,anterior decompression and instrumentation, combined anterior-posterior approach and minimally invasive approach. Howerer,the optimal technique is not always evident. There is no precise classification system to determine which surgical procedure is the best. The following review summarizes the recent advances in treatment of thoracolumbar burst fractures. Recent clinical evidence shows that there is no significant difference between conservative therapy and surgical treatment for thoracolumbar burst fractures without neurologie deficit, and that surgical treatment should be considered for unstable fractures with neurological injuries. Some other clinical evidence shows that short segment combined fractured vertebra plasty with various manners has gained popularity, because it can reconstruct anterior column and decrease the failure of internal fixation and the occurrence of long-term spinal kyphosis deformity. In accordance with the principles of biomechanics and taking into account the occurrence of degeneration of adjacent segment, surgeons gradually applied non-fusion technology in clinical practice, and yet its long-term results need to be confirmed by further studies.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第2期132-136,共5页
Orthopedic Journal of China
关键词
胸腰椎
爆裂骨折
治疗
thoracolumbar vertebrae
burst fractures
treatment
