经伤椎短节段椎弓根固定治疗胸腰段骨折及其对神经功能的改善作用

Short-segment fixation of thoracolumbar fractures using pedicle fixation at level of fracture and its impact on neurological function

目的探讨经伤椎短节段椎弓根固定治疗胸腰段骨折的临床效果及其对神经功能的改善作用。方法 回顾性分析2012年8月~2014年6月中山医院青浦分院收治胸腰段骨折患者24例的临床资料,所有患者均采用经伤椎短节段椎弓根固定治疗。分析术前及术后伤椎前、后缘高度比值、Cobb角、神经功能恢复（Frankel分级）及并发症情况。结果 全部患者术后3 d和末次随访伤椎前、后缘高度比值均显著大于术前,Cobb角均显著低于术前,差异有统计学意义（P〈0.05）,末次随访和术后3 d的伤椎前、后缘高度比值和Cobb角之间比较,差异无统计学意义（P〉0.05）。神经功能损伤的患者术后Frankel分级均有明显改善。结论 经伤椎短节段椎弓根固定能显著恢复伤椎高度和Cobb角度,减少伤椎高度、Cobb角丢失和内固定失败等并发症发生,促进神经功能恢复。

Objective To evaluate the clinical effect and impact on neurological function of short-segment fixation of thoracolumbar fractures using pedicle fixation at the level of the fracture. Methods From August 2012 to June 2014, in Qingpu Branch of Zhongshan Hospital, the clinical data of 24 patients with the thoracolumbar fracturein Zhongshan hospital Qingpu branch were retrospectively analyzed, all the patients were treated with posterior short segment pedicle screw fixation plus pedicle screw in fractured vertebra. The ratio of anterior, posterior vertebral height, Cobb angle and Franked grade, complication were analyzed. Results The rates of anterior, posterior vertebral height after surgery 3 d and final follow-up were higher than those before surgery, Cobb angle was lower than before surgery, the differences were statistically significant （P 〈 0.05）. The Frankel grade of the nerve function damaged patients improved than be- fore. Conclusion The short-segment fixation of thoracolumbar fractures using pedicle fixation at the level of the frac- ture can reconstructed vertebral body height, obtain better kyphosis correction, maintain the correction effect and avoided breakage of the implant, promote the recovery of neurological function.