Surgical Treatment of Thoracolumbar Fractures: A Clinical Analysis of 43 Cases

胸腰椎骨折的外科療法－臨床分析43例

王榮彬(Jung-Pin Wang) ； 黃俊雄(Chun-Hsiung Huang) ； 蘇榮源(Rong-Yuan Su) ； 賴建宏(Jiann-Horng Lai)

《Journal of Orthopaedic Surgery Taiwan》 9卷1期 (1992/03) Pp. 77-83

摘要

馬偕醫院自民國73年1月到78年12月，共手術治療43個胸腰椎骨折的病例，其中男性28位，女生17位，年齡最大為73歲，最小17歲，平均34歲，我們依照丹尼斯分類法來診斷病人，外科治療主要是整合骨折及內固定。整合骨折是最佳減壓治療，堅硬的內固定可以使病人及早下床活動及物理治療。經6個月到70個月的追踪治療，若是完全下半身麻痺，往往不會進步，我們有9個病例，其他不完全下半身麻痺，都可以進步一到二個法蘭克階級。在這5年中，很多新的內固定器械引進台灣。哈靈頓桿、路克桿、日爾基桿、馬格式內固定桿、金田式內固定桿及希弟桿。其實是不論任何內固定器械，最後結果取決於骨黏合是否完整、黏合質塊是否堅硬。本文將回顧我們對於多種脊椎內固定器械的使用經驗。

並列摘要

Forty-three cases of thoracolumbar fractures were treated in Mackay Memorial Hospital from January 1984 to December 1989. After 6 months to 70 months of follow up, there are 2 cases with hook dislodge and 1 wire broken, but no pseudoarthrosis was found. Surgical reduction of thoracolunbar fracture provided anatomical reduction, decompression of bone fragment impingement, early ambulation and rigid fixation of the spine. Neurological recovery improved at least one grade except 9 cases with complete paraplegia (flankle grade I). During this period, many new spinal instrumentations were introduced to Taiwan, including Harringtion, Luque, Zielke, Margel and Kanede. Whatever interval fixator was perfomed, the fusion technique is the most important, and the final result depends on the fusion mass. The purpose of this paper is to review our experience in various types of spinal instrumentation device.

並列關鍵字

thoracolumbar fractures.