Kim Woo Seok, Jeong Tae Seok, Kim Woo Kyung
Department of Traumatology, Gachon University Gil Medical Center, Incheon, Korea.
J Trauma Inj. 2023 Sep;36(3):290-294. doi: 10.20408/jti.2022.0075. Epub 2023 Jun 9.
Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.
一般来说，患有严重爆裂骨折、不稳定或神经功能缺损的患者需要手术治疗。在大多数情况下，需进行环形重建。三柱重建的手术方法包括前路、侧路和后路入路。在涉及前路或侧路入路的病例中，可能需要与普通外科医生或胸外科医生合作，因为脊柱外科医生对相邻的解剖结构不熟悉。风险包括血管或腰丛损伤以及椎间融合器移位，并且在大多数情况下，需要额外进行后路融合手术。然而，后路入路是脊柱外科医生进行手术时最常用且解剖结构熟悉的入路。我们展示了一个病例，该病例仅采用后路入路进行三柱重建，以治疗一名患有严重腰椎爆裂骨折的患者。
