椎管环状减压治疗胸腰椎爆裂性骨折

Annular Decompression of Vertebral Canal for Treating Thoracolumbar Burst Fractures

目的探讨椎管环状减压治疗胸腰椎爆裂性骨折的方法和疗效。方法应用椎管环状减压、AF椎弓根螺钉系统固定及椎体后外侧植骨治疗胸腰椎爆裂性骨折32例。结果按美国脊髓损伤学会(Am erican sp inal in jury assoc iation,ASIA)神经损伤分级标准评定,27例不完全性损伤患者提高1-3级,5例完全性损伤患者部分神经功能有所恢复;术后伤椎高度和矢状面指数(sagital index,SI)有显著改善;螺钉位置全部良好,无折断、弯曲、松动现象。结论椎管环状减压、AF椎弓根螺钉系统及椎体后外侧植骨治疗胸腰椎爆裂性骨折有利于恢复神经功能和脊柱的生理弧度、稳定性。

Objective To discuss the effectiveness and methods of the annular decompression of vertebral canal for thoracolumbar burst fractures. Methods 32 patients with the thoracolumbar burst fractures were treated with the annular decompression, AF pedicle screw system and bone graft at the site of the posterolateral vertebral body. Results According to the American spinal injury association （ ASIA） grading scale, 27 incompletely injured patients had neurologically improved by one to three grades and 5 completely injured patients had neurologically restoration partly ; the height of the injured vertebral body and sagital index （SI） were improved significantly ; and there was no sign of the screw displacement, breaking, flexion and loosing. Conclusion It is benefit for restorating the neurological function, physiological curvature and stability of the spinal column after treating thoracolumbar burst fracture with the annular decompression, AF pedicle screw system and bone graft at the posterolateral vertebral body.