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脊柱的手术稳定:脊柱骨折、脊椎滑脱及内固定方法的临床综述

Surgical Stabilization of the Spine: A Clinical Review of Spinal Fractures, Spondylolisthesis, and Instrumentation Methods.

作者信息

Enache Adrian-Valentin, Toader Corneliu, Onciul Razvan, Costin Horia Petre, Glavan Luca-Andrei, Covache-Busuioc Razvan-Adrian, Corlatescu Antonio-Daniel, Ciurea Alexandru Vlad

机构信息

Sanador Clinical Hospital, 010991 Bucharest, Romania.

Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

出版信息

J Clin Med. 2025 Feb 10;14(4):1124. doi: 10.3390/jcm14041124.

Abstract

The spine is a complex structure critical for stability, force transmission, and neural protection, with spinal fractures and spondylolisthesis posing significant challenges to its integrity and function. Spinal fractures arise from trauma, degenerative conditions, or osteoporosis, often affecting transitional zones like the thoracolumbar junction. Spondylolisthesis results from structural defects or degenerative changes, leading to vertebral displacement and potential neurological symptoms. Diagnostic and classification systems, such as AO Spine and TLICS, aid in evaluating instability and guiding treatment strategies. Advances in surgical techniques, including minimally invasive approaches, pedicle screws, interbody cages, and robotic-assisted systems, have improved precision and recovery while reducing morbidity. Vertebral augmentation techniques like vertebroplasty and kyphoplasty offer minimally invasive options for osteoporotic fractures. Despite these innovations, postoperative outcomes vary, with challenges such as persistent pain and hardware complications necessitating tailored interventions. Future directions emphasize predictive analytics and enhanced recovery strategies to optimize surgical outcomes and patient quality of life.

摘要

脊柱是一个复杂的结构,对稳定性、力的传递和神经保护至关重要,脊柱骨折和椎体滑脱对其完整性和功能构成重大挑战。脊柱骨折由创伤、退行性疾病或骨质疏松引起,常影响胸腰段交界处等过渡区域。椎体滑脱由结构缺陷或退行性改变引起,导致椎体移位并可能出现神经症状。AO脊柱和TLICS等诊断和分类系统有助于评估不稳定性并指导治疗策略。手术技术的进步,包括微创方法、椎弓根螺钉、椎间融合器和机器人辅助系统,提高了手术精度和恢复效果,同时降低了发病率。椎体成形术和后凸成形术等椎体强化技术为骨质疏松性骨折提供了微创选择。尽管有这些创新,术后结果仍存在差异,持续疼痛和内固定并发症等挑战需要针对性的干预措施。未来的方向强调预测分析和强化恢复策略,以优化手术结果和患者生活质量。

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本文引用的文献

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