椎弓根钉系统复位固定治疗无神经症状胸腰椎爆裂性骨折

Application of combining pedicle screw fixation for treatment of thoracolumbar burst fracture without neural symptom

目的探讨后路椎弓根钉系统复位固定加植骨治疗胸腰椎爆裂性骨折的适应证及评价其临床疗效。方法对19例无瘫痪胸腰椎爆裂性骨折患者,男13例,女6例,年龄33·7岁,实施后路椎弓根钉系统撑开复位内固定后植骨的方法进行治疗。结果19例患者术后疼痛均明显缓解,椎体高度和形态得到明显恢复(Cobb角平均改善18°)。经术后平均8·8个月随访,疼痛均消失,骨折均达到满意复位并愈合,随访Cobb角无明显加大、椎体高度无明显丢失,术后无神经损伤、假关节形成和断钉等并发症发生。结论后路椎弓根钉系统固定加植骨术能及时增加椎体稳定性,有助于患者早期活动,是一种治疗胸腰椎爆裂性骨折的有效方法。对于潜在可能出现继发性神经损害的爆裂性胸腰椎骨折应尽早采取合理手术。

Objective Application of combining pedicle screw fixation and bone graft can reconstruct vertebral shape and height,and increase the stability of the spine,and reduce the possibility of breaking of nail and other complications.It can enable the patients to move around as early as possible.Meanwhile it is a good minimal invasive method in treatment of thoracolumbar vertebral burst fractures.Methods Nineteen patients of thoracolumbar vertebral burst fracture without neural symptom,13 males and 6 females,aged 33.7,were treated by combining pedicle screw fixation and bone grafting.Follow-up was conducted for 8.8 months on average.Results The follow-up showed that pain was remarkably relieved or disappeared in all patients.The height and form of the vertebrae were remarkably improved with the Cobb angle improved by 18°,and all fractures reached reposition and healing.No post-operative complication occurred in all cases.Conclusion Application of combining pedicle screw fixation and bone grafting can reconstruct the vertebral shape and height,increase the stability of the spine,and reduce the possibility of breaking of the nail and other complications.It can enable the patients to move around as early as possible.Meanwhile it is a good minimally invasive method in treatment of thoracolumbar vertebral burst fractures.