胸腰椎爆裂骨折术中评估要点分析
The Main Evaluation Points in the Operation of Thoracolumbar Burst Fracture via Posterior Approach
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摘要: [摘要]目的 探讨胸腰椎爆裂骨折后路钉棒手术治疗中如何评估椎管减压是否充分.方法 120例胸腰椎爆裂骨折全部采用后路钉棒技术治疗,术中准确阅读透视图象中椎体后缘“直线”或“前弧线”恢复情况,以此判断椎管占位程度(100%);并做术后CT对比.结果 清楚地观察椎体后缘“直线”或“前弧线”恢复情况,借此准确判断椎管占位程度,与术后CT判断有良好的一致性(98.29%),二者采用配对t检验,没有统计学差异(P>0.05).结论 术中通过透视阅读椎体后缘“直线”或“前弧线”的恢复情况,以判断椎管占位是否解除的方法是准确可行的.Abstract: [Abstract]Objective To investigate how to judge the vertebral canal is decompressed or not in the operation of thoracolumbar burst fracture via posterior approach.Methods 120 thoracolumbar burst fractures were treated with transpedicle screws-rods technique.We observed elaboratively if the posterior border of the burst vertebral body were pushed back into “one-line sign”or“antrorse arc line sign”on lateral fluoroscopy in the operation, and judged if the vertebral canal was decompressed.Comparing the data with CT scans after operation,there is a good concordance between the X-ray in operation and CT scan after operation with this method(P>0.05).Results The posterior border of the burst vertebral body and the dgree of compression of the vertebral canal could be oberved clearly on lateral fluoroscopy in the operation.There was a good concordance between the X-ray in operation and CT scan after operation with this method.Conclusion The“straight line”or “antrorse arc line” can be observed clearly on the fluroscopy in operation.If the decompression for spinal canal be enough can be judged exactly with this method.
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