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[胸腰椎骨折治疗中矢状面平衡的恢复]

[Restoration of sagittal balance in treatment of thoracic and lumbar vertebral fractures].

作者信息

Hempfing A, Zenner J, Ferraris L, Meier O, Koller H

机构信息

Zentrum für Wirbelsäulenchirurgie, Werner-Wicker-Klinik, 34537, Bad Wildungen, Deutschland.

出版信息

Orthopade. 2011 Aug;40(8):690-702. doi: 10.1007/s00132-011-1796-4.

Abstract

Posttraumatic kyphosis (PTK) is a possible consequence of a missed fracture, a wrong indication for conservative therapy or an inadequate surgical technique but PTK can also be a complication after adequate surgery. Avoidance of PTK is of importance because subsequent surgical therapy can be extensive. A thorough planning as well as surgical experience with anterior and posterior revision cases is necessary. The various types of osteotomy which allow correction of local as well as global deformities should also be mastered. Knowledge of the principles of sagittal balance and spinopelvic parameters are indispensable in the treatment of PTK. Our experience and results from the literature show that a good long-term outcome with limited complications can only be achieved when considering the biomechanical principles as well as restoration of sagittal balance.

摘要

创伤后驼背(PTK)可能是漏诊骨折、保守治疗指征错误或手术技术不足的后果,但PTK也可能是充分手术后的并发症。避免PTK很重要,因为后续手术治疗可能范围广泛。进行全面规划以及具备前后路翻修病例的手术经验是必要的。还应掌握各种能矫正局部及整体畸形的截骨术。矢状面平衡和脊柱骨盆参数的原则知识在PTK治疗中不可或缺。我们的经验以及文献结果表明,只有在考虑生物力学原则以及矢状面平衡恢复的情况下,才能实现具有有限并发症的良好长期疗效。

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