前、后路不同手术方式治疗严重腰椎不稳定型骨折的系列性研究-外科学专业论文.docx

前、后路不同手术方式治疗严重腰椎不稳定型骨折的系列性研究英文摘要PartⅡ Analysis between Anterior and Posterior Surgical Treatments ofLumbar Vertebrae Burst FracturesObjective To evaluate results and characteristics of surgical treatments through anterior and posterior approach for lumbar vertebrae burst fractures . Methods The retrospective review included 46 cases of lumbar vertebrae burst fractures receiving surgical treatments from January 2005 to December 2008 ,of whom 18 cases are L1 factures,11 L2 fractures,9 L3 fractures ,6 L4 fractures and 2 L5 fractures. Different approaches were selected according to conditions of injury.33 cases received posterior decompression and transpedicular short-segment fixation (23 cases of bone graft are through posterolateral approach,5 cases through intra vertebral approach and 5 cases through combined posterolateral approach and vertebrolplasty);7 cases received anterior decompression ,bone graft and internal fixation;6 cases received combined posterior decompression , transpedicular fixation and anterior corpectomy with intervertebral fusion through modified small incisions .The nerve function recovery was measured by ASIA standards, and the correction of deformity (Cobb’s angle) and the bone fusion were detected by imaging examination.Results The follow-up studies were conducted regularly. Except no changes in the 3 complete paralysis cases, the ASIA classification of postoperative nerve function in 43 incomplete paralysis cases were improved by 1 grade or more. In the patients who underwent posterolateral fusion, 3 cases were found Cobb’s angle improved accompanied by delayed collapse of the injured vertebra, 5 cases were found with screw breakage and 4 cases with “empty shell phenomenon”. But the Cobb’s angle in the rest cases were significantly improved (p0.05), and the bone graft were fused completely.Discussion Both anterior and posterior surgical approaches can effectively treat lumbar vertebrae burst fractures. The vertebral height, lumbar vertebral