胸腰段骨折的治疗

Abstract 摘要
脊柱最常见的骨折几乎都发生在胸腰段。胸腰段骨折的治疗就是通 过恢复骨折的机械稳定和神经的恢复来达到早期活动和康复的目的，进 而使患者尽早返回工作岗位。 然而在治疗方式的选择上仍然存在着争议。通过对运动感觉神经系 统的检查确定神经损伤并决定恰当的治疗方式。骨折的机械稳定通过X线 平片和CT进行评估。一些案例中，需要使用MRI来评估涉及神经结构或者 后纵韧带联合的软组织损伤。基于这些查体和影像学检查，完成对骨折 稳定性的评估并且决定是否进行保守治疗或者手术治疗。 近年来通过微创手段减少了手术节段而不融合，并且节省耗材。因 还没有明确的证据，所以在使用这些治疗上仍然存在着争议，如果手术 在斟酌骨折类型和创伤严重程度之后进行，病人的手术并发症可以降低 并且可以获得好的临床和影像学结果。
ቤተ መጻሕፍቲ ባይዱ
University, Gumi, Korea 2Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
Abstract 摘要
The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment.
Introduction 引言 Ninety percent of all spine fractures are related to the thoracolumbar region [1]. Especially, the majority of thoracolumbar injuries occur at the T11 to L2 level, which is the biomechanically weak for stress [2]. The causes of thoracolumbar fracture are different depending on patient's age. In younger patients, fracture is more likely to occur due to a high-energy trauma,， such as motor vehicle accident, motorcycle accident, and falling injury. However, in elderly, even falls from standing position to ground can cause fractures due to osteoporosis and decreased cognition [3,4]。
Abstract 摘要
The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity.
Treatment of Thoracolumbar Fracture
胸腰段骨折的治疗
Byung-Guk Kim1, Jin-Myoung Dan1, Dong-Eun Shin2
1Department of Orthopaedic Surgery, CHA Gumi Medical Center, School of Medicine, CHA