Floman Y, Fast A, Pollack D, Yosipovitch Z, Robin G C
Clin Orthop Relat Res. 1986 Apr(205):207-15.
During open reduction of thoracolumbar fracture-dislocation, the normal constraints to distraction and lengthening may be ruptured and allow instrumentation to exert deleterious traction of the spinal cord. An interspinous wire across the unstable segment together with a Harrington rod may be used to prevent potential overdistribution of the spinal cord. Thirty-six patients with fracture-dislocation of the thoracolumbar spine were treated by open reduction with Harrington rods and interspinous wiring. Of 15 patients with a partial cord lesion, four made complete recovery, and nine of the remaining 11 became ambulators. Six patients with a complete paraplegia did not improve; 15 patients remained neurologically intact following the procedure. The compressive wire and Harrington rods act in concert and enable correction of kyphosis and restoration of vertebral and discal height while protecting the cord against traction. The technique is safe and does not add to operative time.
在胸腰椎骨折脱位切开复位过程中,正常的对抗牵引和延长的限制可能会被破坏,从而使器械对脊髓施加有害的牵引力。跨越不稳定节段的棘突间钢丝联合哈灵顿棒可用于防止脊髓潜在的过度伸展。36例胸腰椎骨折脱位患者接受了哈灵顿棒切开复位和棘突间钢丝固定治疗。15例部分脊髓损伤患者中,4例完全恢复,其余11例中有9例能够行走。6例完全性截瘫患者无改善;15例患者术后神经功能保持完整。加压钢丝和哈灵顿棒协同作用,能够矫正后凸畸形,恢复椎体和椎间盘高度,同时保护脊髓免受牵引。该技术安全,且不增加手术时间。