Rekha创伤钉棒系统复位内固定结合经椎弓根椎体植骨治疗胸腰椎骨折

Evaluation of Rekha pedicle screw-bar system and transpedicular bone graft for treatment of thoracolumbar fractures of anterior and intermediolateral column

[目的]探讨Rekha创伤钉棒系统复位内固定结合经椎弓根椎体内植骨治疗胸腰椎前中柱骨折的技术操作特点和疗效。[方法]采用Rekha创伤钉棒系统复位内固定结合经椎弓根椎体植骨治疗胸腰椎前柱骨折或伴随不严重的中柱骨折(后纵韧带完整,CT显示椎管狭窄<30%)14例,术前、术后及随访时X线片检查,测定正侧位X线片成角段Cobb′s角度变化及椎体前后缘高度比值变化,对比治疗前后VAS疼痛评分,观察骨折愈合及椎体高度丢失情况。[结果]术后3～5d常规下地活动,随访6～18个月,VAS(visual analogue scale)评分达到1.29±0.91,术前侧位Cobb′s角13.64°±4.67°,术后2.53°±7.57°,术前椎体前后缘高度比值0.67±0.12,术后为0.96±0.09,均有统计学意义(P<0.01),全部随访病例未出现明显的椎体高度的再丢失,无1例发生内固定断裂、松动。患者生活质量良好。[结论]Rekha创伤钉棒系统结构设计特殊,操作方便快捷,手术时间短,椎体高度回复满意,结合经椎弓根椎体内植骨,断钉断棒的风险小,重建前中柱的稳定性效果良好。

[Objective]To investigate the effect of Rekha pedicle screw-bar system and transpedicular bone graft for the treatment of thoracolumbar fractures of anterior and midst column and discuss the operating technique. [Method] Fourteen cases of thoracolumbar fractures of anterior and midst column were treated by internal fixation with Rekha pedicle screw-bar system and transpedicular bone graft. All were followed up. Pre and post-operation X-ray films were taken, Cobb＇s angles of injured segment and ratio of the height of anterior to posterior side of the centrum were measured. Visual analogue scale was recorded. [Result] All cases were followed up for 6-18 months. Visual analogue scale were 1.29±0.91, Cobb＇s angle were 13.64°±4.67°（preoperation） and 2.53°±7.57°（postoperation）. The ratio of the height of anterior to posterior side of the centrnm were 0.67±0.12（preoperation） and 0.96±0.09（postoperation）, showing significant difference （ P 〈 0.01 ）. There was no lose of correction or nerve complication. Internal fixation system kept integrity. All patients achieved good quality of life. [ Conclusion ] Rekha pedicle screw-bar system is good in design, simply in manipulation,less in blood loses and mild in injury, when used with transpedicular bone graft,it is more effective for treating thoracolumbar fractures of anterior and midst column.