后路椎弓根钉内固定治疗胸腰椎骨折

Treatment of thoracolumbar spinal fractures with internal posterior transpedicular fixation

目的总结应用后路椎弓根钉系统治疗胸腰椎骨折的方法、疗效、并发症。方法用后路椎弓根钉系统(包括AF、RSS、CD、中华长城)手术治疗胸腰椎压缩骨折、爆裂骨折、骨折脱位34例。结果平均随访12个月,与术前相比,椎体前缘高度平均矫正47.3%,平均丢失1.3(%P<0.01);cobb角平均矫正18.3°,平均丢失3.1°(P<0.01);脊髓损伤病人Frankel分级平均提高1级;4例出现并发症,1例置钉松动,1例钉杆连接松动,1例胸膜破裂、1例置钉不当。结论采用椎弓根钉内固定技术治疗胸腰椎骨折,有利于恢复病椎高度,脊柱的生理弧度和神经功能。

[ Objective ] To sum up the ways and results and complications of the treatment for thoracolumbar spine fractures with internal posterior transpedicular fixation. [Methods] Internal posterior transpedicular fixation consisting of AF, RSS, CD and Zhonghua Longwall system was used to treat 34 cases of thoracolumsar spinal fractures, which were followed up for average one year and Checked with radiography and CT scan before/after operation. [Results] （1） Compared with preoperation, the correction of anterior vertebral body height averaged 47.3% with correction loss for average 1.3% and cobb angle was corrected for avenge 18.3°with mean loss of cobb angle for 3.1°. （2） According to Frankel classification, the average recovery paralysis raised 1 grade. （3） The screws of 1 case had loosened and the joints of 1 case had loosened, the screw of 1 case had been mistakenly planted and the pleura of 1 case was teared. [Conclusion] Internal posterior transpedicular fixation treating thoracolumbar spinal fractures can recover body height, physiologic postured contour of the injured spine and neuronal function.