单节段椎弓根螺钉固定治疗胸腰椎骨折的临床观察

Clinical comprehension of thoracolumbar spine fracture treatmented with posterior monosegmental vertebral pedicle screw fixation at the injured vetebrae

目的:探讨经伤椎置钉单节段椎弓根螺钉固定结合后外侧植骨治疗胸腰椎骨折的临床疗效。方法:2009年1月至2010年12月,对l4例胸腰椎骨折采用后路经伤椎置钉单节段椎弓根螺钉固定结合后外侧植骨融合治疗,比较手术前后伤椎椎体前缘高度及Gardner角变化,并观察椎体复位丢失及内固定物情况。结果:平均手术时间83min(52~125min),出血量120mL(50~350mL),无医源性神经损伤;术后所有病例均获得随访,平均随访16.8个月(12~24个月),术后伤椎椎体前缘高度及Gardner角较术前均明显改善,未见内固定松动、断裂、脱出,所有病例均获得骨性融合。结论:单节段椎弓根螺钉固定治疗胸腰椎骨折手术创伤小,临床疗效令人满意,但需严格掌握手术适应证及手术技巧。

[Objective] To evaluate the clinical outcome of thoracolumbar spine fracture treatmented with posterior monosegmental transpedicular fixation at the injured vertevrae.[Method] From January 2009 to December 2010,14 cases of thoracolumbar spine fracture were treated by the surgical procedure of posterior monosegmental injured vertebral pedicle internal fixation and injured vertebra bone grafting fusion.The status of internal fixation material was followed up and the vertebral height and kyphosis angle were compared before and after the surgery.[Result] The mean operation time,average bleeding volume during operation,was 83 min(52~125min),120ml(50~350m1),respectively.There was no iatrogenic nerve injure in all cases.All patients obtained the follow up and the average time was 16.8 months(12~24 moths).No internal fixation material breaking,loose and dislocation were found after operation.Bony union was observed in all cases.Postoperation vertebral height and segmental kyphosis angle different chips were statistically significant.[Conclusion] The posterior monosegmental injured vertebral internal fixation is one of effective method for treating thoracolumbar spine fracture.Strict indication and surgical skill is the key to this procedure.