椎弓根内固定治疗无神经损伤的胸腰椎骨折

Treatment of thoracolumbar vertebral fractures without neurological injury by transvertebral pedicle internal fixation

目的探讨椎弓根螺钉治疗无神经损伤胸腰椎骨折的临床疗效。方法35例患者在局部麻醉下行椎弓根螺钉内固定治疗,未行椎板减压,术后平均随访19个月。结果伤椎前后缘高度和Cobb’s角分别是术前402%、796%、245°,术后935%、973%、47°,随访时878%、942%、49°;椎管截面积术前平均425%,术后934%;各项指标与术前相比有显著差异(P<001)。无迟发性神经损伤发生。结论椎弓根内固定术具有间接椎管减压、恢复和维持脊柱正常序列、防止迟发性神经损伤发生等优点,是治疗该类骨折的较好方法。

Objective:To study the clinical results of patients with thoracolumbar fractures without neurological injury treated by pedicle screws Method:Under local anaesthesia,35 cases were treated by pedicle screw internal fixation without laminectomy,followed up for an average of 19 months Result:The average anterior and posterior height of fractured vertebrae was 40 2%,79 6% preoperatively,93 5%,97 3% postoperatively and 87 8%,94 2% at follow up;Cobb’s angle was 24 5° preoperatively,4 7° postoperatively and 4 9° at follow up The cross section area of spinal canal was 42 5% preoperatively,93 4% postoperatively There was significant deference in targets between pre operation and post operation( P<0 01 ) Late neurological deficits did not occur Conclusion:Pedicle screw instrumentation is a better technique for treating such fractures with the advantages of indirect spinal canal decompression,reconstructing spinal alignment and preventing late neurological deficits