目的 研究改良胸膜外路及植骨 结合侧前方减压固定治疗胸腰椎骨折并脊 髓损伤的效果，并分析CT影像技术在围术 期的应用。方法 选取我院2009年至2015 年收治的46例胸腰椎骨折合并脊髓损伤患 者为研究对象，以上患者均采取改良胸膜 外路及植骨结合侧前方减压固定治疗，于 术前、术后进行多排CT三维重建及常规X 线检查。结果 46例均获得随访，平均12 个月(6-24个月)。除1例患者术中胸膜损 伤以外均未出现损伤腰膨大血管、损伤脏 器、损伤脊髓及术后内固定物松动等并发 症。Frankel分级法显示神经功能明显改 善，46例患者经术后CT重建扫描均显示 骨折复位效果良好，椎管内无压迫。结论 侧前方减压固定治疗胸腰椎骨折并脊髓损 伤减压直接且彻底，CT重建技术应用于胸 腰椎骨折合并脊髓损伤可实现胸腰椎骨折 并脊髓损伤的准确诊断及治疗评估，临床 价值较高。

Objective To study the effects of modified extrapleural approach and bone grafting combined with anterolateral decompression fixation in the treatment of thoracolumbar fractures and spinal cord injuries and to analyze the application of CT imaging technique in perioperative period. Methods 46 patients with thoracolumbar fractures and spinal cord injuries treated in our hospital from 2009 to 2015 were selected as the research objects. These patients were treated with modified extrapleural approach and bone grafting combined with anterolateral decompression fixation. Multislice CT three dimensional reconstruction and routine X-ray examination were performed before and after operation. Results All the 46 cases were followed up for 12 months in average (6-24 months). Except for 1 patient with intraoperative pleural injury, there were no angiomegaly of injured waist, injured organs, injured spinal cord, postoperative internal fixation loosening and other complications. Frankel grading method showed obvious improvement of nerve function. After postoperative CT reconstruction scanning, 46 patients showed good effects of fracture reduction and there was no oppression in the spinal canal. Conclusion Anterolateral decompression fixation in the treatment of thoracolumbar fractures and spinal cord injuries is direct and complete. The application of CT reconstruction technique in thoracolumbar fractures and spinal cord injuries can achieve accurate diagnosis and treatment evaluation of the disease.