目的 探讨中上胸椎多节段骨折外科治疗的时机和方法.方法 分析35例胸椎多节段骨折患者的临床资料.观察后路手术术前以及术后1、3、6个月临床症状以及神经功能恢复情况,了解早期后路手术对患者生活质量的影响.其中按Frankle分级标准神经损伤情况为:A级6例,B级7例,C级9例,D级8例,E级5例.结果 经1～6个月年的随访,患者神经功能和临床症状均有不同程度的改善:术后1个月,Frankle分级无明显变化(P = 0.16),术后3个月和6个月Frankle分级较术前明显改善(P ＜ 0.01).术后6个月较术后1个月,瘫痪平面改善明显(P = 0.02).结论 中上胸椎多节段骨折应尽早实施后路手术.%Objective To discuss the opportunity and method of the posterior route operation in the upper-middle thoracic fracture. Methods The clinical data of 35 patients with upper-middle thoracic fracture were reviewed. The clinical symptoms and nerve function recovery were obersed before the operation and after treatment for 1 month, 3 months, 6 months to learn the effect of the surgical treatment by posterior approach on the life quality of the patients. A ccording to Frankle grade, there were 6 cases of grade A, 7 cases of grade B, 9 cases of grade C, 8 cases of grade D, 5 cases of grade E. Results All cases were followed up for 1 month-6 months. The clinical symptoms and nerve function of the patients were improved. One month after the operation, the Frankle grade had no significant change. The Frankle grade changed significantly ( all P < 0.01) after treatment for 1 month and 6 months. The Situation in 6 months after operation compared with 1 month postoperatively, paralysis plane improved significantly (P = 0.02). Contusion The upper-middle thoracic vertebral fracture should be operated with the surgical treatment by posterior approach early.
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