Benzel E C, Larson S J
Division of Neurosurgery, Louisiana State University Medical Center, Shreveport 71130-3932.
J Spinal Disord. 1989 Mar;2(1):47-51.
A review of 109 case histories of patients who had undergone a spine fusion and/or posterior instrumentation procedure for thoracic and/or lumbar spine trauma was performed with respect to efficacy of several postoperative external splinting techniques. These data formed the basis for a review of external spinal splinting techniques. The type of orthosis that appears to offer the most efficacious immobilization and maximum patient comfort for fractures in the upper thoracic region in a body shell jacket extending from the submental and suboccipital regions to the lumbar region (modified Minerva jacket). To gain a lower point of fixation in patients with mid-to-low lumbar fractures, it was found that an extended body shell or an extension of a body jacket to one leg (hip spica) was necessary. Thoracic and thoracolumbar injuries may be stabilized with either a Jewett brace or a body jacket. The lack of maintenance of the cylindrical body shell, as well as excessive discomfort, make the Jewett brace and similar orthotic devices a second choice to body shell jackets for fractures in this region. The application of plastic polymer (Thermoplast) to spine splinting techniques offers the patient increased comfort and stability, as well as facilitating easy application and a more snug fit.
针对几种术后外部夹板固定技术的疗效，对109例因胸段和/或腰段脊柱创伤接受脊柱融合和/或后路内固定手术的患者的病历进行了回顾。这些数据构成了对外部脊柱夹板固定技术进行综述的基础。对于上胸段骨折，似乎能提供最有效固定且患者舒适度最高的矫形器类型是一种从颏下和枕下区域延伸至腰段的躯壳式夹克（改良密涅瓦夹克）。为了在中低位腰椎骨折患者中获得更低的固定点，发现有必要使用延长的躯壳或将躯壳式夹克延伸至一条腿（髋人字石膏）。胸段和胸腰段损伤可用朱厄特支具或躯壳式夹克进行稳定固定。由于缺乏对圆柱形躯壳的维持，以及过度不适，对于该区域的骨折，朱厄特支具和类似的矫形装置成为躯壳式夹克的第二选择。将塑料聚合物（热塑性塑料）应用于脊柱夹板固定技术，能为患者提供更高的舒适度和稳定性，同时便于应用且贴合度更高。
