前路与后路减压治疗胸腰段骨折合并脊髓损伤疗效的Meta分析
|
摘要
目的:系统评价前路减压(anterior decompression)与后路减压(posterior decompression)治疗胸腰段骨折合并脊髓损伤的疗效与安全性,为胸腰段骨折合并脊髓损伤的疗效提供更好的科学依据。方法:检索并收集前路减压与后路减压治疗胸腰段骨折合并脊髓损伤的比较性研究。通过计算机检索下列数据库:Pubmed、Embase、Cochrane图书馆、CNKI、CBM、万方医学网。人工检索期刊Spine、European Spine Journal、The Journal of Bone and Joint Surgery。2名脊柱外科专业人员按照既定的纳入与排除标准,独立筛选文献,并对各纳入的研究进行质量评价。使用Review Manager5.3软件对数据进行Meta分析,观察指标包括手术时间、术中出血量、术后触觉评分、术后运动评分、术后伤椎高度、住院时间、神经功能恢复、治疗有效率及术后并发症。结果:最终纳入15项随机对照试验(randomized controlled trail,RCT),共1360例患者,其中前路减压术680例,后路减压术680例。Meta分析结果示,与后路减压组相比,前路减压组手术时间长[MD=80.09,95%CI(36.83,123.34),P=0.0003],术中出血量多[MD=225.21,95%CI(171.07,279.35),P<0.00001],住院时间长[MD=2.31,95%CI(0.32,4.31),P=0.02],术后触觉评分高[MD=13.39,95%CI(9.86,16.92),P<0.00001],术后运动评分高[MD=13.15,95%CI(7.02,19.29),P<0.0001],伤椎高度高[MD=1.36,95%CI(0.79,1.92),P<0.00001],而两者在治疗有效率[OR=1.14,95%CI(0.56,2.31),P=0.72]、神经功能恢复[OR=0.87,95%CI(0.57,1.33),P=0.52]方面,差异均无统计学意义。结论:前路减压与后路减压相比,手术时间长,术中出血量多,住院时间长,术后触觉评分高,术后运动评分高,伤椎高度高,但是两者在治疗有效率、神经功能恢复方面差异无统计学意义。
Objective:To systematically evaluate the efficacy and safety of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury,so as to provide a good scientific basis for more effective treatment of thoracolumbar fractures with spinal cord injury. Methods:A clinical data about comparative study of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury was searched and collected. The databases of Pubmed,Embase,Cochrane Library,CNKI,CBM,Wanfang Medical Network were searched by computer. Artificially collected journals included Spine,European Spine Journal,The Journal of Bone and Joint Surgery. Two spine surgeons independently screened the literature according to established inclusion and exclusion criteria and assessed the quality of the included studies. Meta-analysis was performed on the data using Review Manager 5.3 software,the indicators included operative time,intraoperative blood loss,postoperative tactile score,postoperative motor score,postoperative vertebral height,hospitalization time,neurological function recovery,efficiency of treatment,postoperative complications.Results:Fifteen randomized controlled trials(RCTs) were enrolled in a total of 1360 patients,including 680 anterior decompression and 680 posterior decompression. The results of Meta-analysis showed that the anterior decompression group had longer operation time [MD=80.09,95% CI(36.83,123.34),P=0.0003],more intraoperative blood loss [MD=225.21,95%CI(171.07,279.35),P<0.00001],longer hospitalization time [MD=2.31,95% CI(0.32,4.31),P=0.02]. And the postoperative tactile score [MD=13.39,95% CI(9.86,16.92),P<0.00001],postoperative motor score [MD=13.15,95% CI(7.02,19.29),P<0.0001],vertebral height [MD=1.36,95% CI(0.79,1.92),P<0.00001] in anterior decompression were higher than that in posterior decompression. There was no statistically significant differences in the efficacy of treatment [OR=1.14,95% CI(0.56,2.31),P=0.72],neurological recovery [OR=0.87,95% CI(0.57,1.33),P=0.52] between two groups. Conclusion:Compared with posterior decompression,the anterior decompression has the advantages of longer operating time,more intraoperative blood loss,longer hospitalization time,higher postoperative tactile score,higher postoperative motor score,and higher injury vertebral height,But there was no significant difference in the treatment efficiency and nerve function recovery between two groups.
Objective:To systematically evaluate the efficacy and safety of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury,so as to provide a good scientific basis for more effective treatment of thoracolumbar fractures with spinal cord injury. Methods:A clinical data about comparative study of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury was searched and collected. The databases of Pubmed,Embase,Cochrane Library,CNKI,CBM,Wanfang Medical Network were searched by computer. Artificially collected journals included Spine,European Spine Journal,The Journal of Bone and Joint Surgery. Two spine surgeons independently screened the literature according to established inclusion and exclusion criteria and assessed the quality of the included studies. Meta-analysis was performed on the data using Review Manager 5.3 software,the indicators included operative time,intraoperative blood loss,postoperative tactile score,postoperative motor score,postoperative vertebral height,hospitalization time,neurological function recovery,efficiency of treatment,postoperative complications.Results:Fifteen randomized controlled trials(RCTs) were enrolled in a total of 1360 patients,including 680 anterior decompression and 680 posterior decompression. The results of Meta-analysis showed that the anterior decompression group had longer operation time [MD=80.09,95% CI(36.83,123.34),P=0.0003],more intraoperative blood loss [MD=225.21,95%CI(171.07,279.35),P<0.00001],longer hospitalization time [MD=2.31,95% CI(0.32,4.31),P=0.02]. And the postoperative tactile score [MD=13.39,95% CI(9.86,16.92),P<0.00001],postoperative motor score [MD=13.15,95% CI(7.02,19.29),P<0.0001],vertebral height [MD=1.36,95% CI(0.79,1.92),P<0.00001] in anterior decompression were higher than that in posterior decompression. There was no statistically significant differences in the efficacy of treatment [OR=1.14,95% CI(0.56,2.31),P=0.72],neurological recovery [OR=0.87,95% CI(0.57,1.33),P=0.52] between two groups. Conclusion:Compared with posterior decompression,the anterior decompression has the advantages of longer operating time,more intraoperative blood loss,longer hospitalization time,higher postoperative tactile score,higher postoperative motor score,and higher injury vertebral height,But there was no significant difference in the treatment efficiency and nerve function recovery between two groups.
引文
[1]王放,贺西京.短节段椎弓根钉棒固定治疗无神经损伤胸腰椎骨折对长期生活质量的影响[J].中国骨伤,2015,28(1):12-16.WANG F,HE XJ. Short-segment pedicle screw fixation for the treatment of thoracolumbar fracture without nerve injury and its long-term quality of life[J]. Zhongguo Gu Shang/China J Orthop Trauma,2015,28(1):12-16. Chinese with abstract in English.
[2] TANG P,LONG A,SHI T,et al. Analysis of the independent risk factors of neurologic deficit after thoracolumbar burst fracture[J]. J Orthop Surg Res,2016,11(1):128.
[3] YAN YB,QI W,WU ZX,et al. Finite element study of the mechanical response in spinal cord during the thoracolumbar burst fracture[J]. PLoS One,2012,7(9):e41397.
[4] Reinholl M,Knop C,Beisse R,et al. Operative treatment of traumatic fractures of the thorax and lumbar spine. PartⅡ:surgical treatment and radiological findings[J]. Unfallchirurg, 2009,112(2):149-167.
[5]郑超,伍骥,黄蓉蓉,等.前路手术治疗成人胸腰段Denis B型爆裂性骨折[J].中华创伤杂志,2014,30(7):669-674.ZHENG C,WU J,HUANG RR,et al. Anterior surgical treatment of Denis B-type burst fracture in adult thoracolumbar section[J].Zhonghua Chuang Shang Za Zhi,2014,30(7):669-674. Chinese.
[6] LI S,LI Z,HUA W,et al. Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation:Case report and literature review[J]. Medicine(Baltimore),2017,96(49):e8770.
[7] Beaudette SM,Graham RB,Brown SH. The effect of unstable loading versus unstable support conditions on spine rotational stiffness and spine stability during repetitive lifting[J]. J Biomech,2014,47(2):491-496.
[8]姚杰,李飞翔,岳璠.胸腰段脊柱神经损伤的临床治疗观察[J].中国实用神经疾病杂志,2017,20(13):97-99.YAO J,LI FX,YUE P. Clinical treatment of thoracolumbar spinal nerve injury[J].Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2017,20(13):97-99. Chinese.
[9]裴冬阳,饶耀剑.胸腰段脊柱骨折伴脊髓损伤的临床治疗[J].世界临床医学,2017,11(4):51-53.PEI DY,RAO YJ. Thoracic and lumbar spinal fractures with clinical treatment of spinal cord injury[J]. Shi Jie Lin Chuang Yi Xue,2017,11(4):51-53. Chinese.
[10]吴涛.经前路与后路手术对胸腰段骨折伴脊髓损伤患者的疗效对比[J].医疗装备,2016,29(20):80-81.W U T. Comparison of anterior and posterior surgery for thoracolumbar fracture with spinal cord injury[J]. Yi Liao Zhuang Bei,2016,29(20):80-81. Chinese.
[11]张健.胸腰段脊柱脊髓损伤患者的治疗效果观察[J].中国实用神经疾病杂志,2016,19(19):131-132.ZHANG J. Therapeutic effect of thoracolumbar spinal cord injury in patients[J]. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2016,19(19):131-132. Chinese.
[12]郭马珑,崔宏勋,杨磊,等.不同入路减压治疗胸腰段脊柱骨折合并脊髓神经损伤疗效分析[J].世界最新医学信息文摘,2016,16(32):77-78.GUO ML,CUI HX,YANG L,et al. Treatment of thoracolumbar spine fracture with spinal nerve injury by different approaches and decompression[J]. Shi Jie Zui Xin Yi Xue Xin Xi Wen Zai,2016,16(32):77-78. Chinese.
[13]李飞.经前后路手术治疗胸腰段骨折伴脊髓损伤临床观察[J].首都食品与医药,2016,(2):36-37.LI F. After anterior and posterior surgery for the treatment of horacolumbar fracture with spinal cord injury[J]. Shou Du Shi Pin Yu Yi Yao,2016,(2):36-37. Chinese.
[14]王琦,尚平,才忠民.前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的临床效果[J].临床医学工程,2015,22(9):1193-1194.WANG Q,SHANG P,CAI ZM. Anterior and posterior decompression for the treatment of thoracolumbar spine fracture with spinal cord injury[J]. Lin Chuang Yi Xue Gong Cheng,2015,22(9):1193-1194. Chinese.
[15]黄殿锋.前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的临床对照研究[J].当代医学,2015,22(17):95-96.HUANG DF. Aunterior and posterior decompression in the treatment of thoracolumbar spine fracture with spinal cord injury:a clinical comparative study[J]. Dang Dai Yi Xue,2015,22(17):95-96.Chinese.
[16] Cui H,Guo J,Yang L,et al. Comparison of therapeutic effects of anterior decompression and posterior decompression on thoracolumbar spine fracture complicated with spinal nerve injury[J].Pak J Med Sci, 2015,31(2):346-350.
[17]未东兴.前路减压内固定与后路融合术对胸腰段骨折并发脊髓损伤运动功能的影响[J].白求恩医学杂志,2014,12(6):572-573.WEI DX. Anterior decompression and internal fixation with posterior fusion in the treatment of thoracolumbar fracture complicated with spinal cord injury motor function[J].Bai Qiu En Yi Xue Za Zhi,2014,12(6):572-573. Chinese.
[18]曾凯斌,胡优威,谭益云.前后路减压治疗胸腰段脊柱骨折合并脊髓神经损伤的效果分析[J].中国实用神经疾病杂志,2014,17(18):80-81.ZENG KB,HU YW,TAN YY. Anterior and posterior decompression for the treatment of thoracolumbar spine fracture with spinal nerve injury[J]. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2014,17(18):80-81. Chinese.
[19]袁小平.经前路与后路手术治疗胸腰段骨折伴脊髓损伤临床对比研究[J].中外医疗,2014,33(27):27-28.YUAN XP. Anterior and posterior surgical treatment of thoracolumbar fracture with spinal cord injury in clinical comparison[J].Zhong Wai Yi Liao,2014,33(27):27-28. Chinese.
[20]庞小林,伏新,吴仁春.经前后路手术治疗胸腰段骨折伴脊髓损伤临床效果分析[J].中国实用神经疾病杂志,2014,17(10):93-94.PANG XL,FU X,WU RC. After anterior and posterior surgery for the treatment of thoracolumbar fracture with spinal cord injury clinical effect analysis[J]. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2014,17(10):93-94. Chinese.
[21]姜棚菲.前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的临床对照研究[D].延安大学,2013.JIANG PF. Anterior and posterior decompression for the treatment of thoracolumbar spine fracture with spinal cord injury:a clinical comparative study[D]. Yan An University,2013. Chinese.
[22]张红,刘战立,常山,等.经前后路手术治疗胸腰段骨折伴脊髓损伤88例疗效分析[J].海南医学,2012,23(21):68-69.ZHANG H, LIU ZL, CHANG S, et al. Anterior and posterior surgery for the treatment of thoracolumbar fracture with spinal cord injury in88 cases[J]. Hai Nan Yi Xue,2012,23(21):68-69. Chinese.
[23]胡日鹤,周初松.胸腰段脊柱骨折伴脊髓损伤的治疗方法体会[J].中国医药指南,2012,10(20):22-23.HU RH,ZHOU CS. Thoracic and lumbar spinal fracture with spinal cord injury treatment experience[J]. Zhongguo Yi Yao Zhi Nan,2012,10(20):22-23. Chinese.
[24] Wood KB,Li W,Lebl DR,et al. Management of thoracolumbar spine fractures[J]. Spine J,2014,14(1):145-164.
[25] Liang C,Liu B,Zhang W,et al. Clinical effects of posterior limited long-segment pedicle instrumentation for the treatment of thoracolumbar fractures[J]. J Invest Surg, 2018,1:1-6.
[26] Wu H,Zhao DX,Jiang R,et al. Surgical treatment of Denis type B thoracolumbar burst fracture with neurological deficiency by paraspinal approach[J]. Braz J Med Biol Res,2016,49(11):e5599.
[27] Tang J,Liu Y,Hu Y,et al. Anterior decompression with single segmental spinal interbody fusion for Denis type B thoracolumbar burst fracture:a midterm follow-up study[J]. Int Orthop,2013,37(11):2205-2209.
[28] Kuang Y,Yu ZX,Liu YW. Clinical efficacy of semi-laminectomyand posterior stabilization for treatment of thoracolumbar burst fracture[J]. Int J Surg, 2013,11(9):807-810.
[29] Yan L,Liu Y,He B,et al. Clinical case-series report of traumatic cauda equina herniation:A pathological phenomena occurring with thoracolumbar and lumbar burst fractures[J]. Medicine(Baltimore),2017,96(14):e6446.
[30] Verlaan JJ,Diekerhof CH,Buskens E,et al. Surgical treatment of traumatic fractures of the thoracic and lumbar spine:a systematic review of the literature on techniques, complications, and outcome[J]. Spine(Phila Pa 1976),2004,29(7):803-814.
[31]王程,阙伊辰,宋西正,等.新型外固定器联合椎体植骨在相邻双节段胸腰椎骨折中的应用[J].中国骨伤,2018,31(8):714-717.WANG C,QUE YC,SONG XZ,et al.New external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting for the treatment of two-segment thoracolumbar fractures[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(8):714-717. Chinese with abstract in English.
[32]徐强,赵清华,赵志慧,等.单双侧伤椎置钉与不置钉在治疗胸腰椎骨折上的病例对照研究[J].中国骨伤,2018,31(8):709-713.XU Q,ZHAO QH,ZHAO ZH,et al. Case control studies on unilateral or bilateral pedicle fixation at the level of fracture versus posterior fixation alone in the treatment of thoracolumbar fractures[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(8):709-713. Chinese with abstract in English.
[33] Liu JM,Long XH,Zhou Y,et al. Is urgent decompression superior to delayed surgery for traumatic spinal cord injury? A Meta-analysis[J]. World Neurosurg,2016,87:124-131.
[34]徐荣明,孙韶华,马维虎,等.特发性脊柱侧凸手术并发症分析[J].中国骨伤,2008,21(4):245-248.XU RM,SUN SH,MA WH,et al. Analysis of complications in scoliosis surgery[J]. Zhongguo Gu Shang/China J Orthop Trauma,2008,21(4):245-248. Chinese with abstract in English.
[35]周章彦,周茂垣,连福明,等.围手术期综合救治对颈前路手术并发症的影响[J].中国骨伤,2006,19(12):754.ZHOU ZY,ZHOU MY,LIAN FM,et al. Effects of perioperative synthetic cures on complications of anterior cervical surgery[J].Zhongguo Gu Shang/China J Orthop Trauma,2006,19(12):754.Chinese.
[36]杨国谋,王敏,贺灵慧,等.腰椎间盘突出症早期手术并发症的回顾性分析[J].中国骨伤,2006,19(2):116-117.YANG GM,WANG M,HE LH,et al. Retrospective analysis of early post-operative complication in lumbar intervertebral disc herniation[J]. Zhongguo Gu Shang/China J Orthop Trauma,2006,19(2):116-117. Chinese.
[2] TANG P,LONG A,SHI T,et al. Analysis of the independent risk factors of neurologic deficit after thoracolumbar burst fracture[J]. J Orthop Surg Res,2016,11(1):128.
[3] YAN YB,QI W,WU ZX,et al. Finite element study of the mechanical response in spinal cord during the thoracolumbar burst fracture[J]. PLoS One,2012,7(9):e41397.
[4] Reinholl M,Knop C,Beisse R,et al. Operative treatment of traumatic fractures of the thorax and lumbar spine. PartⅡ:surgical treatment and radiological findings[J]. Unfallchirurg, 2009,112(2):149-167.
[5]郑超,伍骥,黄蓉蓉,等.前路手术治疗成人胸腰段Denis B型爆裂性骨折[J].中华创伤杂志,2014,30(7):669-674.ZHENG C,WU J,HUANG RR,et al. Anterior surgical treatment of Denis B-type burst fracture in adult thoracolumbar section[J].Zhonghua Chuang Shang Za Zhi,2014,30(7):669-674. Chinese.
[6] LI S,LI Z,HUA W,et al. Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation:Case report and literature review[J]. Medicine(Baltimore),2017,96(49):e8770.
[7] Beaudette SM,Graham RB,Brown SH. The effect of unstable loading versus unstable support conditions on spine rotational stiffness and spine stability during repetitive lifting[J]. J Biomech,2014,47(2):491-496.
[8]姚杰,李飞翔,岳璠.胸腰段脊柱神经损伤的临床治疗观察[J].中国实用神经疾病杂志,2017,20(13):97-99.YAO J,LI FX,YUE P. Clinical treatment of thoracolumbar spinal nerve injury[J].Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2017,20(13):97-99. Chinese.
[9]裴冬阳,饶耀剑.胸腰段脊柱骨折伴脊髓损伤的临床治疗[J].世界临床医学,2017,11(4):51-53.PEI DY,RAO YJ. Thoracic and lumbar spinal fractures with clinical treatment of spinal cord injury[J]. Shi Jie Lin Chuang Yi Xue,2017,11(4):51-53. Chinese.
[10]吴涛.经前路与后路手术对胸腰段骨折伴脊髓损伤患者的疗效对比[J].医疗装备,2016,29(20):80-81.W U T. Comparison of anterior and posterior surgery for thoracolumbar fracture with spinal cord injury[J]. Yi Liao Zhuang Bei,2016,29(20):80-81. Chinese.
[11]张健.胸腰段脊柱脊髓损伤患者的治疗效果观察[J].中国实用神经疾病杂志,2016,19(19):131-132.ZHANG J. Therapeutic effect of thoracolumbar spinal cord injury in patients[J]. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2016,19(19):131-132. Chinese.
[12]郭马珑,崔宏勋,杨磊,等.不同入路减压治疗胸腰段脊柱骨折合并脊髓神经损伤疗效分析[J].世界最新医学信息文摘,2016,16(32):77-78.GUO ML,CUI HX,YANG L,et al. Treatment of thoracolumbar spine fracture with spinal nerve injury by different approaches and decompression[J]. Shi Jie Zui Xin Yi Xue Xin Xi Wen Zai,2016,16(32):77-78. Chinese.
[13]李飞.经前后路手术治疗胸腰段骨折伴脊髓损伤临床观察[J].首都食品与医药,2016,(2):36-37.LI F. After anterior and posterior surgery for the treatment of horacolumbar fracture with spinal cord injury[J]. Shou Du Shi Pin Yu Yi Yao,2016,(2):36-37. Chinese.
[14]王琦,尚平,才忠民.前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的临床效果[J].临床医学工程,2015,22(9):1193-1194.WANG Q,SHANG P,CAI ZM. Anterior and posterior decompression for the treatment of thoracolumbar spine fracture with spinal cord injury[J]. Lin Chuang Yi Xue Gong Cheng,2015,22(9):1193-1194. Chinese.
[15]黄殿锋.前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的临床对照研究[J].当代医学,2015,22(17):95-96.HUANG DF. Aunterior and posterior decompression in the treatment of thoracolumbar spine fracture with spinal cord injury:a clinical comparative study[J]. Dang Dai Yi Xue,2015,22(17):95-96.Chinese.
[16] Cui H,Guo J,Yang L,et al. Comparison of therapeutic effects of anterior decompression and posterior decompression on thoracolumbar spine fracture complicated with spinal nerve injury[J].Pak J Med Sci, 2015,31(2):346-350.
[17]未东兴.前路减压内固定与后路融合术对胸腰段骨折并发脊髓损伤运动功能的影响[J].白求恩医学杂志,2014,12(6):572-573.WEI DX. Anterior decompression and internal fixation with posterior fusion in the treatment of thoracolumbar fracture complicated with spinal cord injury motor function[J].Bai Qiu En Yi Xue Za Zhi,2014,12(6):572-573. Chinese.
[18]曾凯斌,胡优威,谭益云.前后路减压治疗胸腰段脊柱骨折合并脊髓神经损伤的效果分析[J].中国实用神经疾病杂志,2014,17(18):80-81.ZENG KB,HU YW,TAN YY. Anterior and posterior decompression for the treatment of thoracolumbar spine fracture with spinal nerve injury[J]. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2014,17(18):80-81. Chinese.
[19]袁小平.经前路与后路手术治疗胸腰段骨折伴脊髓损伤临床对比研究[J].中外医疗,2014,33(27):27-28.YUAN XP. Anterior and posterior surgical treatment of thoracolumbar fracture with spinal cord injury in clinical comparison[J].Zhong Wai Yi Liao,2014,33(27):27-28. Chinese.
[20]庞小林,伏新,吴仁春.经前后路手术治疗胸腰段骨折伴脊髓损伤临床效果分析[J].中国实用神经疾病杂志,2014,17(10):93-94.PANG XL,FU X,WU RC. After anterior and posterior surgery for the treatment of thoracolumbar fracture with spinal cord injury clinical effect analysis[J]. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi,2014,17(10):93-94. Chinese.
[21]姜棚菲.前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的临床对照研究[D].延安大学,2013.JIANG PF. Anterior and posterior decompression for the treatment of thoracolumbar spine fracture with spinal cord injury:a clinical comparative study[D]. Yan An University,2013. Chinese.
[22]张红,刘战立,常山,等.经前后路手术治疗胸腰段骨折伴脊髓损伤88例疗效分析[J].海南医学,2012,23(21):68-69.ZHANG H, LIU ZL, CHANG S, et al. Anterior and posterior surgery for the treatment of thoracolumbar fracture with spinal cord injury in88 cases[J]. Hai Nan Yi Xue,2012,23(21):68-69. Chinese.
[23]胡日鹤,周初松.胸腰段脊柱骨折伴脊髓损伤的治疗方法体会[J].中国医药指南,2012,10(20):22-23.HU RH,ZHOU CS. Thoracic and lumbar spinal fracture with spinal cord injury treatment experience[J]. Zhongguo Yi Yao Zhi Nan,2012,10(20):22-23. Chinese.
[24] Wood KB,Li W,Lebl DR,et al. Management of thoracolumbar spine fractures[J]. Spine J,2014,14(1):145-164.
[25] Liang C,Liu B,Zhang W,et al. Clinical effects of posterior limited long-segment pedicle instrumentation for the treatment of thoracolumbar fractures[J]. J Invest Surg, 2018,1:1-6.
[26] Wu H,Zhao DX,Jiang R,et al. Surgical treatment of Denis type B thoracolumbar burst fracture with neurological deficiency by paraspinal approach[J]. Braz J Med Biol Res,2016,49(11):e5599.
[27] Tang J,Liu Y,Hu Y,et al. Anterior decompression with single segmental spinal interbody fusion for Denis type B thoracolumbar burst fracture:a midterm follow-up study[J]. Int Orthop,2013,37(11):2205-2209.
[28] Kuang Y,Yu ZX,Liu YW. Clinical efficacy of semi-laminectomyand posterior stabilization for treatment of thoracolumbar burst fracture[J]. Int J Surg, 2013,11(9):807-810.
[29] Yan L,Liu Y,He B,et al. Clinical case-series report of traumatic cauda equina herniation:A pathological phenomena occurring with thoracolumbar and lumbar burst fractures[J]. Medicine(Baltimore),2017,96(14):e6446.
[30] Verlaan JJ,Diekerhof CH,Buskens E,et al. Surgical treatment of traumatic fractures of the thoracic and lumbar spine:a systematic review of the literature on techniques, complications, and outcome[J]. Spine(Phila Pa 1976),2004,29(7):803-814.
[31]王程,阙伊辰,宋西正,等.新型外固定器联合椎体植骨在相邻双节段胸腰椎骨折中的应用[J].中国骨伤,2018,31(8):714-717.WANG C,QUE YC,SONG XZ,et al.New external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting for the treatment of two-segment thoracolumbar fractures[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(8):714-717. Chinese with abstract in English.
[32]徐强,赵清华,赵志慧,等.单双侧伤椎置钉与不置钉在治疗胸腰椎骨折上的病例对照研究[J].中国骨伤,2018,31(8):709-713.XU Q,ZHAO QH,ZHAO ZH,et al. Case control studies on unilateral or bilateral pedicle fixation at the level of fracture versus posterior fixation alone in the treatment of thoracolumbar fractures[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(8):709-713. Chinese with abstract in English.
[33] Liu JM,Long XH,Zhou Y,et al. Is urgent decompression superior to delayed surgery for traumatic spinal cord injury? A Meta-analysis[J]. World Neurosurg,2016,87:124-131.
[34]徐荣明,孙韶华,马维虎,等.特发性脊柱侧凸手术并发症分析[J].中国骨伤,2008,21(4):245-248.XU RM,SUN SH,MA WH,et al. Analysis of complications in scoliosis surgery[J]. Zhongguo Gu Shang/China J Orthop Trauma,2008,21(4):245-248. Chinese with abstract in English.
[35]周章彦,周茂垣,连福明,等.围手术期综合救治对颈前路手术并发症的影响[J].中国骨伤,2006,19(12):754.ZHOU ZY,ZHOU MY,LIAN FM,et al. Effects of perioperative synthetic cures on complications of anterior cervical surgery[J].Zhongguo Gu Shang/China J Orthop Trauma,2006,19(12):754.Chinese.
[36]杨国谋,王敏,贺灵慧,等.腰椎间盘突出症早期手术并发症的回顾性分析[J].中国骨伤,2006,19(2):116-117.YANG GM,WANG M,HE LH,et al. Retrospective analysis of early post-operative complication in lumbar intervertebral disc herniation[J]. Zhongguo Gu Shang/China J Orthop Trauma,2006,19(2):116-117. Chinese.