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全椎体切除术及脊柱缩短术治疗急性胸椎骨折脱位:技术要点及3例报告

Total vertebrectomy and spine shortening in the management of acute thoracic spine fracture dislocation: technical note and report of 3 cases.

作者信息

Obeid Ibrahim, Guérin Patrick, Gille Olivier, Gangnet Nicolas, Aurouer Nicolas, Pointillart Vincent, Vital Jean-Marc

机构信息

Department of Orthopaedic Surgery, University Hospital of Bordeaux, Spinal Unit, Bordeaux, France.

出版信息

J Spinal Disord Tech. 2011 Jul;24(5):340-5. doi: 10.1097/BSD.0b013e3181f9a447.

Abstract

STUDY DESIGN

Case report of 3 thoracic spine fracture-dislocations with complete spinal cord section treated by total vertebrectomy--spine shortening through a posterior approach.

OBJECTIVES

To assess the usefulness and safety of this surgical technique in the treatment of acute thoracic spine fracture-dislocation.

SUMMARY OF BACKGROUND

Total vertebrectomy can be used in different nontraumatic disorders. This surgical procedure has been used in the chronic phase of traumatic thoracolumbar dislocation. To our knowledge, the technique of total vertebrectomy and spine shortening in the acute phase of thoracic spine fracture dislocation has never been reported.

MATERIAL AND METHODS

Three patients who suffered thoracic spine fracture-dislocation with ASIA A paraplegia underwent complete vertebrectomy and spine shortening through a posterior approach. We report technical details, clinical, and radiologic results at 24 months minimum follow-up.

RESULTS

Complete vertebrectomy of the fractured vertebra involved T5 in 1 patient, T7 in another, and T10 in the third. There were no perioperative complications. At latest follow-up, fusion was obtained in all 3. Overall sagittal and coronal alignment was restored.

CONCLUSIONS

Complete vertebrectomy and spinal shortening can be used in the acute phase to manage thoracic spine fracture-dislocations.

摘要

研究设计

3例胸椎骨折脱位伴脊髓完全横断患者经后路全椎体切除术——脊柱短缩的病例报告。

目的

评估该手术技术治疗急性胸椎骨折脱位的有效性和安全性。

背景概述

全椎体切除术可用于不同的非创伤性疾病。该手术已用于创伤性胸腰椎脱位的慢性期。据我们所知,胸椎骨折脱位急性期的全椎体切除术和脊柱短缩技术从未被报道过。

材料与方法

3例胸椎骨折脱位伴美国脊髓损伤协会(ASIA)A级截瘫的患者接受了经后路全椎体切除术和脊柱短缩术。我们报告了至少随访24个月时的技术细节、临床和影像学结果。

结果

1例患者骨折椎体为T5,另1例为T7,第3例为T10,均进行了骨折椎体的全椎体切除。无围手术期并发症。在最近的随访中,3例均获得融合。整体矢状面和冠状面排列恢复。

结论

全椎体切除术和脊柱短缩术可用于急性期胸椎骨折脱位的治疗。

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