三点支撑矫形复位内固定结合三维植骨融合治疗胸腰椎爆裂性骨折

Treatment of Thoracolumbar Fracture with Three-point pedestal Orthopedic Reposition Internal Fixation and Three Diamensions Bone Grafting Method

目的探讨采用三点支撑矫形复位内固定技术结合三维植骨融合治疗胸腰椎爆裂性骨折的临床疗效。方法采用三点支撑矫形复位内固定技术结合三维植骨融合治疗胸腰椎爆裂性骨折38例,手术前后及随访期间摄x线片,测定椎体成角、上下终板成角、椎体前缘高度与正常高度的比值,了解术后骨折复位情况以及随访期间内固定有无失败和复位丢失情况。结果通过手术复位,椎体成角、上下终板成角、椎体前缘高度与正常高度的比值均明显改善,术后随访测量以上结果与术后相比无明显变化,无一例发生内固定失败。结论采用三点支撑矫形复位内固定技术结合三维植骨融合治疗胸腰椎爆裂性骨折可有效地防止内固定失败以及脊柱骨折复位丢失和后凸畸形,是治疗胸腰椎爆裂性骨折较理想的方法。

Objective Investigate the clinic effect of the three-point pedestal orthopedic reposition internal fixation and three diamensions bone grafting method to treat thoracolumbar burst fracture. Methods Thirty-eight patients with thoracolumbar burst fracture were treated using the three-point pedestal orthopedic reposition internal fixation and three diamensions bone grafting method. Take X-ray in the perioperative and follow-up phase,the radiological outcomes include the vertebral angle, the superior-inferior endplate angle and the ratio of anterior body height to the normal height. The radiographs obtained during the follow-up period were also analyzed to find if there was any failure of the instrumentation. Results Theoperative reduction had an satisfactory effect on the vertebral angle, the superior-inferior endplate angle and the ratio of anterior body heighl to the normal height. The correction loss was not significant during the follow-up period. There was no failure of the instrumentation found during the follow-up period. Conclusion The three-point pedestal orthopedic reposition internal fixation and three diamensions bone grafting method can prevent failure of short——segment fixation, and it is a good method in treatment of thoracolumbar burst fractures.