经椎间孔椎间植骨治疗胸腰段骨折脱位的临床及影像学研究

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Abstract Objective To explore the clinical effect of transforaminal thoracic interbody fusion (TTIF) for the treatment of thoracolumbar fracture-dislocations.Methods 42 consecutive patients with thoracolumbar fracture-dislocations underwent TTIF in our institution but four patients could not be followed up.Radiographs and computed tomography (CT) data was prospective examined and compared.The clinical outcome was measured in terms of the American Spinal Injury Association (ASIA) score，perioperative complications related to operation.Results These 38 patients include 24males and 14 females，with an average age of (39.4±9.7) years.The mean duration between injury and surgery was 17.6 (11～23) hours of the 38 patients，all operative procedure was successfully.There were 5 cerebral spinal fluid leakages.The mean operative time was (170±30)min.The blood loss was (820±110)mL，the mean ASIA sensory score was (77.9±12.2) and (90.5±11.8).The average ASIA motor score was (70.5±7.2) and (83.5±9.1) before surgery and at the final follow-up，respectively.The spinal canal narrowing decreased from (72.8±4.5)％ before surgery to 4.0±2.1)％ at the final follow-up，the solid fusion rate was 100％.There was radiological sign of instrumentation failure at the final follow-up.Conclusion Our findings suggest that TTIF allows for safe interbody fusion and circumferential decompression，requires only a posterior approach，and is associated with a lower incidence of surgery-related complications.

Key words： transforaminal interbody fusion thoracolumbar fracture-dislocation circumferential decompression neural recovery surgery related complications

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