胸腰椎爆裂性骨折伴椎管占位且无神经症状的手术治疗策略

铭雨 朱(张家港市第一人民医院，中国)
黎明 王(张家港市第一人民医院，中国)
卫平 沙(张家港市第一人民医院，中国)

摘要

目的： 本研究旨在探索胸腰椎爆裂性骨折伴椎管占位且无神经症状的患者，后路内固定基础上如何选择是否行椎板切除减压？方法： 分别记录两组患者平均年龄、性别及骨折节段，分析术中骨折椎体前缘高度、椎管容积比、Cobb 角相对于术前的变化。术后 1 月、 12 月记录相关参数的变化。 结果： 相比较于术前，减压组术中的骨折椎体前缘高度恢复不明显、椎管容积比改善不显著、Cobb 角矫正差（p>0.05），而非减压组术中间接复位后椎体前缘高度显著恢复、椎管容积比明显增大、Cobb 角明显减小（p<0.05）。在后期随访中，两组椎体前缘高度、椎管容积比、Cobb 角以及 AMS 参数无明显变化。 结论： 后路内固定时，发现椎管内骨折有所回纳，即使回纳不完全，如果伤椎前缘高度显著恢复、椎管容积比明显增大、后凸畸形得到矫正的情况下，可以不需要行后路椎板切除直接减压，亦可获得良好的临床疗效。

关键词

胸腰椎爆裂性骨折；椎管占位；无神经症状；手术方式

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DOI: http://dx.doi.org/10.26549/yzlcyxzz.v2i5.2732