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关节镜辅助下单孔入路脊柱手术治疗合并神经症状的腰椎爆裂骨折:一例报告

Arthroscopic-assisted uniportal spinal surgery for treatment of lumbar burst fractures complicated with neurological symptoms: a case report.

作者信息

Chen Hai-Wei, Wang Zhi-Qiang, Jing Peng-Ju, Ma Dong-Hong, Wang Wen-Bo, Song En, Li Pei-Wu, Cheng Peng

机构信息

Department of Emergency Medicine, The Second Hospital of Lanzhou University, Lanzhou, Gansu, PR China.

Department of Orthopedics, The Second Hospital of Lanzhou University, Lanzhou, Gansu Province, PR China.

出版信息

J Int Med Res. 2025 Jan;53(1):3000605241312828. doi: 10.1177/03000605241312828.

Abstract

Lumbar burst fractures account for 21% to 58% of all thoracolumbar fractures. L5 lumbar burst fractures are rare, comprising 1.2% of spinal burst fractures. This report discusses the optimal treatment for an adolescent with an L5 lumbar burst fracture and neurological symptoms caused by a high-fall injury, which involved surgical decompression and spinal fixation. Complete decompression and fixation of the L5 lumbar burst fracture, complicated by neurological symptoms, were achieved using arthroscopic-assisted uniportal spinal surgery (AUSS) combined with percutaneous pedicle screw fixation (PPSF). The AUSS approach, used alongside PPSF, significantly improved the vertebral canal occupation rate, increased the anterior edge height ratio of the damaged vertebra, and alleviated the lower back pain and nerve root symptoms postoperatively. AUSS combined with PPSF is a minimally invasive technique for treating lumbar burst fractures, effectively relieving compression of the vertebral canal and nerves caused by fracture fragments.

摘要

腰椎爆裂骨折占所有胸腰椎骨折的21%至58%。L5腰椎爆裂骨折较为罕见,占脊柱爆裂骨折的1.2%。本报告讨论了一名因高处坠落伤导致L5腰椎爆裂骨折并伴有神经症状的青少年的最佳治疗方法,该方法包括手术减压和脊柱固定。采用关节镜辅助单通道脊柱手术(AUSS)联合经皮椎弓根螺钉固定(PPSF),实现了对伴有神经症状的L5腰椎爆裂骨折的完全减压和固定。与PPSF一起使用的AUSS方法显著提高了椎管占位率,增加了受损椎体的前缘高度比,并减轻了术后下背部疼痛和神经根症状。AUSS联合PPSF是一种治疗腰椎爆裂骨折的微创技术,可有效缓解骨折碎片对椎管和神经的压迫。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5638/11783536/e8e0463cb008/10.1177_03000605241312828-fig1.jpg

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