Keene J S, Lash E G, Kling T F
Division of Orthopedic Surgery, University of Wisconsin Clinical Science Center, Madison 53792.
J Orthop Trauma. 1988;2(3):202-11. doi: 10.1097/00005131-198802030-00005.
A review of 106 consecutive patients who had operative stabilization of thoracolumbar fractures revealed that 16 patients had surgery 4 months to 13 years after injury, for chronic instability. In these 16 patients, there were 8 wedge-compression fractures, 6 flexion-distraction injuries, 1 burst fracture, and 1 fracture-dislocation. All six patients with flexion-distraction injuries and the two patients with either a burst fracture or a fracture-dislocation had good results. Only two of the eight patients with wedge-compression fractures had good results. We concluded from this study that: (a) instability that presents without a progressive spinal deformity may go unrecognized; (b) all types of spine fractures can produce chronic, painful instability; and (c) poor results predominate in wedge-compression fractures operated more than 13 months after injury, regardless of the type of surgical treatment rendered.
对106例接受胸腰椎骨折手术固定的连续患者进行回顾发现，16例患者因慢性不稳定在受伤后4个月至13年接受了手术。在这16例患者中，有8例楔形压缩骨折、6例屈曲牵张损伤、1例爆裂骨折和1例骨折脱位。所有6例屈曲牵张损伤患者以及2例爆裂骨折或骨折脱位患者均取得了良好效果。8例楔形压缩骨折患者中只有2例取得了良好效果。我们从这项研究中得出结论：(a) 无进行性脊柱畸形的不稳定可能未被识别；(b) 所有类型的脊柱骨折都可导致慢性疼痛性不稳定；(c) 受伤后13个月以上接受手术的楔形压缩骨折，无论采用何种手术治疗方式，效果大多不佳。
