AF内固定并经椎管椎体内植骨治疗胸腰椎爆裂骨折

Treatment of Thoracolumbar Burst Fracture with AF Device Fixation and Vertebral Body Graft via Spinal Canal

目的探讨AF内固定并经椎管椎体内植骨的手术方式和临床疗效。方法对41例胸腰椎爆裂型骨折行AF内固定,并经椎管椎体内植骨及后路植骨,术后卧床2-4周,腰背肌锻炼,腰围固定。结果随访36例,随访时间3月-32月,平均17.5月。根据手术前后影像学评价(椎体高度的恢复,椎管侵占率、脊核后凸cobb's角)和神经功能评价(Frankel分级),优良率80.5%,无松动断钉等情况。结论AF固定对于治疗胸腰椎爆裂骨折有良好复位、固定作用,同时行经椎管椎体内植骨,能增强脊柱前柱的抗压稳定性,再加上后路植骨,能提高脊柱融合率。

Objective To approach the operative method and clinic effect of AF device fixation and vertebral body graft via spinal canal for treatment of thoraeolumbar burst fracture. Methods 41 eases with thoraeolumbar burst fracture were treated with AF device fixation and vertebral body bone graft via spinal canal and posterior bone graft. After 2-4 weeks of operation, the patient could perform some muscular activities. The back was wrapped with the waist fixation Results 36 eases were followed up in3 months to 2 years and 8 months, which gained excellent and good resuhs, （ 80.5% ） through evaluations of fluoroscopy （ recovery of the height of lumbar vertebras, the invasion of the tube and the Cobb angle of the spinal surface ） and neuro pathological function （ Frankel grade ） of inter-operation and postoperation no breaking of nails and shafts, and other complications. Conclusion AF fixation can restore and fix the thoraeolumbar spinal burst fracture, vertebral body graft via spinal canal and posterior bone graft can increase the stability of the spine.