Tan Boon Beng, Chan Chris Yin Wei, Saw Lim Beng, Kwan Mun Keong
Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Indian J Orthop. 2012 Nov;46(6):710-3. doi: 10.4103/0019-5413.104235.
Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS). We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.
不稳定型脊柱骨折常见于多发伤患者。治疗的目的是平衡早期手术稳定的需求，并防止手术带来的额外创伤。最近发表的文献表明，早期稳定不稳定型脊柱骨折具有益处，尤其是在损伤严重程度评分（ISS）较高的患者中。我们报告两例多发伤合并不稳定型脊柱骨折的病例，采用微创经皮椎弓根螺钉内固定系统进行稳定，作为损伤控制手术的一种形式。患者从多发伤中恢复良好。这两个病例说明了微创稳定技术在多发伤情况下作为损伤控制手术形式治疗不稳定型脊柱骨折中的作用、局限性及技术陷阱。
