Riska E B, Myllynen P
Zentralbl Chir. 1981;106(6):355-68.
Of 206 patients with vertebral fractures in the thoraco-lumbar spine with spinal cord injuries, an antero-lateral decompression with stabilization of the injured segment of the vertebral column was undertaken in 56 cases. In all these cases there was a compression of the spinal cord from the front. 8 patients made a complete recovery, 31 a good recovery, and 6 were improved. In 8 patients no improvement was noted. 2 patients developed pressure sores later and 1 patient died one year after the operation of uraemia. 22 patients out of 55 got a normal function of the bladder and 25 patients out of 54 a normal function of the anal sphincter. 16 patients out of 17 made a complete or good recovery after removal of a displaced rotated vertebral bony fragment from the spinal canal, and 7 patients out of 9 with wedge shaped fractures. In our clinic today, in cases of vertebral fractures with neural involvement, reduction and internal fixation with Harrington rods and fusion of the injured segment is undertaken as soon as possible, also during the night. If narrowing of the neural canal and compression of the spinal cord are verified, a decompression operation with interbody fusion is undertaken during the next days.
在206例胸腰椎椎体骨折合并脊髓损伤的患者中，56例患者接受了前路减压并对损伤的椎体节段进行了固定。在所有这些病例中，脊髓均受到前方压迫。8例患者完全恢复，31例恢复良好，6例有所改善。8例患者未见改善。2例患者术后出现压疮，1例患者术后1年死于尿毒症。55例患者中有22例膀胱功能恢复正常，54例患者中有25例肛门括约肌功能恢复正常。17例患者中有16例在从椎管内取出移位旋转的椎体骨碎片后完全或良好恢复，9例楔形骨折患者中有7例恢复。在我们今天的诊所中，对于伴有神经受累的椎体骨折病例，一旦确诊，尽快进行哈灵顿棒复位内固定并对损伤节段进行融合，即使在夜间也进行。如果证实存在神经根管狭窄和脊髓受压，则在接下来的几天内进行椎间融合减压手术。
