Flexion Distraction Injury of the Thoracolumbar Spine-Results of Surgical Treatment

胸腰椎彎屈拉張性傷害—手術治療的結果

馬筱笠(Hsiao-Li Ma) ； 劉建麟(Chien-Lin Liu) ； 郜漢中(Hang-Chung Kao) ； 余榮光(Wing-Kuang Yu) ； 羅惠熙(Wai-Hee Lo)

《Journal of Orthopaedic Surgery Taiwan》 8卷4期 (1991/12) Pp. 313-326

摘要

胸腰彎屈拉張性受傷的特徵為脊椎後方向前延伸的傷害，此種少見的傷害可以是單純的骨折，也可以是軟組織的撕裂傷或是丙種型式的合併。從1987至1989兩年的時間內我們共經歷了五例此種經由意外或車禍造成的脊椎傷害。患者都是年輕人，其中一位合併有神經受損;一位是保守治療失敗的陳舊性傷害。受傷的部位都位於腰椎第一或第二節，所有受傷的脊椎倱有顯著的前屈變形。我們使用手術的方式由背側做開放復位，並用脊椎內固定器以壓迫性或拉張或的方式固定並加上骨融合。
手術後患者祇需穿戴輕便背架即可早日下床活動或接受復健治療。在平均兩年的追蹤檢查，脊椎變形都得到良好矯正而無明顯的改變。所有骨折或骨融合都完全癒合。有四位患者全無症狀，而一位患者的神經傷害雖有顯著的進步，但其偶有輕微背痛的情形。綜觀以手術治療的經驗及結果，我們認為對於此種常合併有顯著前屈變形的脊椎傷害的治療，開放式復位加內固定賽及骨融合不失為一值得信賴的方法。

並列摘要

Flexion distraction injury of the lumbar spine is characterized by disruption of posterior elements of the spine. The pattern of this in common injury may be all bone, all ligament and disc, or combination of the two.
From 1987 to 1989, five cases of flexion distraction injury of the thoracolumbar spine were diagnosed and treated. One patient had neurological deficit while the others were neurologically intact after injury. Kyphotic deformity was present in each of them, and the short segment angulation was measured from 20 to 32 degrees with an average of 25.6 degrees. All of them wee operated within the first 5 days except one who was a victim from failed conservative treatment. Open reduction, internal stabilization with posterior spinal instrumentation and fusion were done in all of them. Postoperatively, they could be mobilized soon after wearing a light-weight brace.all of them have been followed up regularly for an average of 24 months. The clinical results revealed that all had no pain, and full functional recovery except the one with neurological deficit. The radiographic results revealed that all had solid union and no progression of kyphosis except one with loss of 5 degrees of correction. The final correction was from 4 degress of lordosis to 8 degrees of kyphosis. Since significant kyphotic deformity is usually present and the overall results are satisfactory, which encourage us to continue using posterior spinal stabilization and fusion in this unusual injury.

並列關鍵字

Roy-Camille plate ； fixateur interne ； fulcrum fracteur