Paraspinal muscle approach plus dorsomedian laminectomy approach for thoracolumbar fractures with spinal cord injury
10.3760/cma.j.issn.1671-7600.2017.03.014
- VernacularTitle:椎旁肌及后正中椎板剥离联合入路在合并脊髓损伤胸腰段骨折中的应用
- Author:
Zaijiong ZHANG
;
Jingliang ZHANG
;
Lei ZHANG
;
Zhendui WEI
- Keywords:
[Key word] Spinal fractures;
Fracture fixation,internal;
Bone nails;
Paraspinal muscle approach;
Median approach
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(3):261-264
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical efficacy of screwing via the paraspinal muscle approach plus single-segment laminectomy decompression via the dorsomedian approach for thoracolumbar fractures complicated with spinal cord injury.Methods From February 2013 to September 2015,21 patients with thoracolumbar fracture plus spinal cord injury were treated at our department.They were 15 men and 6 women,aged from 20 to 54 years (average,33.2 years).The injury was located at T1 1 in 2 cases,at T12 in 6,at T12 and L1 in one,at L1 in 7 and at L2 in 5;the injury was rated as grade A in one case,grade B in 3 cases,grade C in 8 and grade D in 9 according to the American Spinal Injury Association (ASIA) grading system.A1 the patients were treated by screwing via the paraspinal muscle approach followed by single-segment laminectomy decompression via the dorsomedian approach.Results The operation time averaged 116.1 + 24.5 minutes and the amount of bleeding 580.7 + 80.8 mL.At 3 days after surgery and the final follow-up,their visual analogue scale (VAS) score,anterior vertebral height and cobb angle were significantly improved in comparison with the preoperative values (P ＜ 0.05).At the final follow-up,their Japanese Orthopaedic Association (JOA) the score were also significantly better than the preoperative one (P ＜ 0.05),giving 12 excellent cases,6 good ones and 3 fair ones.Their ASIA grading at the final follow-up showed one case of grade B,2 cases of grade C,6 cases of grade D and 12 cases of grade E.Conclusion Treatment of thoracolumbar fractures complicated with spinal cord injury by crewing via the paraspinal muscle approach plus single-segment laminectomy decompression via the dorsomedian approach is a good way due to limited invasion,less bleeding,simple operation,excellent reduction,reliable fixation and rapid recovery.
