椎管开窗减压结合椎弓根固定治疗椎管侵占胸腰椎爆裂骨
折
田耘;周方;姬洪全;张志山;郭琰;吕扬
【期刊名称】《中华创伤杂志》 【年(卷),期】2014(030)010
【摘要】Objective To detect the possibility of posterior laminar fenestration combined with screw instrumentation for treatment of thoracolumbar burst fracture with canal encroachment.Methods Between January 2005 and December 2008,52 patients with AO-A3 thoracolumbar fracture underwent laminar fenestration to achieve canal decompression and pedicle screw instrumentation without interbody fusion.Canal encroachment,loss of anterior vertebral height,Cobb' s angle,and neurologic outcome were measured before and after operation.Results All patients were followed up for 24 months.Canal encroachment improved from preoperative (68.3 ± 15.1)% to postoperative (11.5-3.9)% (P < 0.05).Cobb' s angle reduced from preoperative (32.5 ± 3.2) ° to postoperative (4.9-± 0.6) ° (P < 0.05).Loss of anterior vertebral height restored from preoperative (50.1 ± 5.6) % to postoperative (85.5 ± 5.1) % (P < 0.05).At the final follow-up,neurological recovery and fracture healing with no apparent vertebral height loss were noted for all patients.Conclusion Flaminar fenestration combined with pedicle screw stabilization attains good