Bedbrook G M
Clin Orthop Relat Res. 1975 Oct(112):27-43.
Ninety per cent of fractures of the dorsal lumbar spine with paraparesis or paraplegia can be best treated and reduced by closed methods when satisfactory alignment can be obtained. The pathology of the corc can thus be allowed to regress and recover if it will do so. Strict posturing techniques are the most important part of medical and nursing care. Approximately 10 per cent of the cases can be treated by gentle, active surgical techniques such as manipulation under general anesthesia or open reduction. The use of spinal rods and clamps is rarely indicated. Surgical techniques may be advisable later for treatment of non-union with spinal stenosis and failure to improve.
对于伴有轻瘫或截瘫的胸腰椎骨折,若能获得满意的对线,90%的病例可通过闭合方法得到最佳治疗和复位。如果脊髓病理情况能够恢复,便可任其自行消退和恢复。严格的体位技术是医疗和护理的最重要部分。约10%的病例可采用轻柔、积极的手术技术治疗,如全身麻醉下的手法操作或切开复位。很少需要使用脊柱棒和夹子。对于伴有椎管狭窄的骨不连且病情无改善的情况,后期采用手术技术可能是可取的。