Cecchinato R, Berjano P, Damilano M, Lamartina C
2nd Division of Spine Surgery, IRCCS Istituto Ortopedico Galeazzi, via R. Galeazzi, 4-20161, Milan, Italy.
Eur J Orthop Surg Traumatol. 2014 Jul;24 Suppl 1:S31-7. doi: 10.1007/s00590-014-1464-6. Epub 2014 Apr 28.
Fractures of the thoracolumbar junction can lead to regional kyphosis, this being a significant cause of pain and disability for the patients. After a traumatic fracture of the thoracolumbar spine, early or late regional kyphosis can be observed. This post-traumatic deformity can, however, be corrected with appropriate surgical methods. Posterior tricolumnar osteotomies are some of the most powerful methods of correction and are particularly indicated when sagittal and coronal deformities have to be simultaneously corrected or when anterior surgery is not possible. Anterior corpectomy and lengthening with posterior instrumentation are, however, an alternative technique to restore the anterior column support and to correct the regional kyphotic deformity and an option for appropriate sagittal balance restoration and control of symptoms. Proper surgical technique, evaluation of the bone quality and identification of eventual extension of the deformity to the thoracic spine are key aspects in prevention of failures.
胸腰段交界处骨折可导致局部后凸，这是患者疼痛和残疾的重要原因。胸腰椎创伤性骨折后，可观察到早期或晚期局部后凸。然而，这种创伤后畸形可通过适当的手术方法进行矫正。后路三柱截骨术是一些最有效的矫正方法，尤其适用于需要同时矫正矢状面和冠状面畸形或无法进行前路手术的情况。然而，前路椎体切除并后路器械延长是恢复前柱支撑、矫正局部后凸畸形以及恢复适当矢状面平衡和控制症状的替代技术。正确的手术技术、骨质评估以及确定畸形是否最终延伸至胸椎是预防手术失败的关键因素。
