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中华老年骨科与康复电子杂志 ›› 2026, Vol. 12 ›› Issue (04) : 250 -256. doi: 10.3877/cma.j.issn.2096-0263.2026.04.008

综述

胸腰椎骨折脱位(AO-C型损伤)手术复位的临床研究进展
薛浩, 戴威, 王冠忠, 胡晨波, 罗飞, 张承旻†()   
  1. 400038 陆军军医大学第一附属医院骨科
  • 收稿日期:2025-05-27 出版日期:2026-08-05
  • 通信作者: 张承旻
  • 基金资助:
    重庆市器官智能生物制造工程研究中心开放项目(CQERC-OIBM20241015)

Thoracolumbar fracture dislocation (AO type C injury): clinical advances in surgical reduction

Hao Xue, Wei Dai, Guanzhong Wang, Chengbo Hu, Fei Luo, Chengmin Zhang†()   

  1. Department of Orthopaedics, Southwest Hospital, The First Affiliated Hospital of Army Medical University, No. 30 Gaotanyan Zhengjie, Shapingba District, Chongqing 400038, China
  • Received:2025-05-27 Published:2026-08-05
  • Corresponding author: Chengmin Zhang
引用本文:

薛浩, 戴威, 王冠忠, 胡晨波, 罗飞, 张承旻. 胸腰椎骨折脱位(AO-C型损伤)手术复位的临床研究进展[J/OL]. 中华老年骨科与康复电子杂志, 2026, 12(04): 250-256.

Hao Xue, Wei Dai, Guanzhong Wang, Chengbo Hu, Fei Luo, Chengmin Zhang. Thoracolumbar fracture dislocation (AO type C injury): clinical advances in surgical reduction[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2026, 12(04): 250-256.

胸腰椎骨折脱位(AO-C型损伤)通常是因为高能量创伤造成脊柱三柱损伤,是最严重的一类脊柱骨折。由于存在屈曲或牵张性损伤,并常同时伴有多个方向的剪切力,因此具有手术复位难度大、硬膜破裂损伤风险高的特点。目前关于AO-C型损伤手术治疗的文献多以个案报道为主,且对于不同平面、不同机制AO-C型损伤的复位技术,还在不断探索。因此本文对AO-C型损伤手术治疗的最新进展进行综述,并着重对手术复位技术进行介绍,同时提出个体化复位技术的流程图,为术者提供参考。

Thoracolumbar fracture-dislocation (AO-type C injury) is usually caused by high-energy trauma resulting in three-column spinal injury, and represents the most severe type of spinal fracture. Characterized by flexion- or distraction-type injury, it is frequently accompanied by multi-directional shear forces, which contribute to great difficulty in surgical reduction and a high risk of dural tear injury. At present, most available literature on the surgical management of AO-type C injuries consists mainly of case reports, and reduction techniques for AO-type C injuries at different spinal levels and with different injury mechanisms are still under continuous exploration. Therefore, this article reviews the latest advances in the surgical treatment of AO-type C injuries, with an emphasis on surgical reduction techniques. Meanwhile, a flow chart for individualized reduction techniques is proposed to provide references for surgeons.

图1 Li,Y的新型切开复位技术  图2 Hadgaonkar的平行棒复位技术  图3 Anokwute的四棒复位技术  图4 Guo等的长弯曲棒复位技术  图5 Mallepally的矫形撑开器复位技术
图6 AO-C型损伤复位技术流程图
图7 直接缝合修复  图8 "包裹式"硬膜贴片修复
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