| 后路短节段结合骨折椎椎弓根螺钉复位内固定治疗胸腰椎骨折 |
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Received:November 25, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 顾勇杰 |
GU Yong-jie |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
epartment of Spinal Surgery,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
gyj1982@hotmail.com |
| 胡勇 |
HU Yong |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
epartment of Spinal Surgery,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 马维虎 |
MA Wei-hu |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
epartment of Spinal Surgery,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
epartment of Spinal Surgery,the Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年23卷，第4期，第264-267页 |
| DOI：10.3969/j.issn.1003-0034.2010.04.009 |
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目的：探讨后路短节段结合骨折椎椎弓根螺钉复位内固定治疗胸腰椎骨折的可行性及临床疗效。
方法：自2005年9月至2007年9月，行后路短节段结合骨折椎椎弓根螺钉复位内固定治疗胸腰椎骨折82例，其中男50例，女32例；年龄18～63岁，平均36岁；病程2 h～7 d,平均2 d.骨折根据AO分型：A1型25例，A2型48例，B2型9例。根据ASIA脊髓神经功能损伤分级：C级9例，D级17例，E级56例。术中将椎弓根螺钉置入骨折椎与相邻的上下椎体中，复位固定，后外侧植骨融合。
结果：82例患者均获得随访，时间12～24个月，平均18.3个月，无一例内固定断裂或松动，全部获得骨性融合。术后骨折椎的椎体前缘压缩率及Cobb角均明显小于术前(P<0.05),而术后随访骨折椎的椎体前缘压缩率及Cobb角与术后相比无明显变化(P>0.05);术后骨折椎的尾侧椎间盘高度(h/H)与术前相比无明显变化(P>0.05).不完全性神经损伤术后脊髓神经功能有1～2级的恢复。
结论：后路短节段结合骨折椎椎弓根螺钉复位内固定治疗胸腰椎骨折是安全可靠的方法，在骨折椎前柱撑开的同时可有效控制正常椎间盘高度的撑开，并有利于矫正后凸畸形和维持矫正效果 |
| [关键词]:胸椎 腰椎 脊柱骨折 内固定器 |
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| Treatment of thoracolumbar vertebral fractures with posterior short segmental pedicle screw fixation and pedicle screw at the fracture level |
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Abstract:
Objective: To explore the feasibility and clinical effects of posterior short segmental pedicle screw fixation adding pedicle screw at the fracture level in treatment of thoracolumbar vertebral fractures.
Methods: From September 2005 to September 2007,82 patients(male 50 and female 32,the age from 18 to 63 years,at mean age of 36 years,the courses of disease from 2 hours to 7 days with an average of 2 days) with thoracolumbar fractures were treated with posterior short segmental pedicle screw fixation adding pedicle screw at the fracture level. According to the AO classification,25 patients were type A1 fracture,48 were type A2 and 9 were type B2. According to the ASIA neurological function grading system,9 patients were grade C,17 were grade D and 56 were grade E. Reduction and posterolateral fusion were achieved through fixation of the fractured vertebra and the adjacent normal vertebrae with the transpedicle screw.
Results: Eighty-two cases were followed up from 12 to 24 months(averaged 18.3 months). All cases achieved bone fusion,without significant lose of the vertebrae body height and implant failure. The anterior body compression and Cobb angle were significantly improved after surgery(P<0.05). The anterior body compression and Cobb angle did not significantly lose compared with after-surgery ones(P>0.05). The caudal intervertebral disc height(h/H)were not significantly improved after surgery(P>0.05). Improvement of one to two grades of neurological function was observed in patients with incomplete neurological injuries.
Conclusion: Posterior short segmental pedicle screw fixation with pedicle screw at the fracture level is a safe and effective therapeutic option to treat thoracolumbar vertebral fractures,which can help to correct the kyphosis and maintain the reduction,and avoid the over-distraction of the contiguous discs. |
| KEYWORDS:Thoracic vertebrae Lumbar vertebrae Spinal fractures Internal fixators |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 顾勇杰,胡勇,马维虎,徐荣明.后路短节段结合骨折椎椎弓根螺钉复位内固定治疗胸腰椎骨折[J].中国骨伤,2010,23(4):264~267 |
| 英文格式: | GU Yong-jie,HU Yong,MA Wei-hu,XU Rong-ming.Treatment of thoracolumbar vertebral fractures with posterior short segmental pedicle screw fixation and pedicle screw at the fracture level[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(4):264~267 |
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