Shaffrey C I, Shaffrey M E, Whitehill R, Nockels R P
Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689, USA.
Neurosurg Clin N Am. 1997 Oct;8(4):519-40.
Many studies indicate that spinal canal decompression and stabilization lead to improved neurologic recovery in patients with incomplete neurologic deficits. It is recognized that surgical stabilization of unstable thoracolumbar injuries with complete neurologic deficit or without deficit reduces hospital stay, improves spinal alignment, shortens rehabilitation, and results in fewer medical complications. Unfortunately, many aspects of management remain controversial. For many injuries, more than one treatment method has been shown to be efficacious, although certain injuries have improved outcome with specific treatment modalities. This article is an overview of indications for surgery, operative approaches, types of instrumentation, and treatment options for specific thoracolumbar injuries.
许多研究表明,椎管减压和稳定术可使不完全神经功能缺损患者的神经功能恢复得到改善。人们认识到,对伴有完全神经功能缺损或无神经功能缺损的不稳定胸腰椎损伤进行手术稳定,可缩短住院时间、改善脊柱排列、缩短康复时间并减少医疗并发症。不幸的是,治疗的许多方面仍存在争议。对于许多损伤,已证明不止一种治疗方法有效,尽管某些损伤采用特定治疗方式可改善预后。本文概述了特定胸腰椎损伤的手术适应证、手术入路、内固定类型及治疗选择。