前路减压植骨K形钢板固定治疗胸腰椎骨折并截瘫

Treatment of Fracture of Thoracolumbar Spine with Paraplegia by Anterior Decompression,Autografts and K-plate Internal Fixation

目的探讨前路减压植骨融合及K形钢板固定治疗胸腰椎骨折并截瘫的临床效果。方法分析2001-06/2006-06采用前路减压植骨及K形钢板内固定术治疗46例胸腰椎骨折患者的手术优缺点、适应证、手术入路及内固定的选择。结果随访8～48个月,平均19个月。术后伤椎高度恢复90%者34例,恢复80%者12例,K形钢板无断裂和松动现象。术后脊髓神经功能能按Frankel分级,除A级8例未能恢复外,其余恢复1～3级。结论前路减压植骨内固定是集直视下直接减压、复位、矫正畸形、植骨内固定、重建脊柱稳定性一次完成的有效方法。K形钢板是治疗胸腰椎骨折较理想的内固定系统。

Objective To study the clinical effects of thoracolumbar fractures treated by anterior decompression, with autografts and internal fixation by k-plate system. Methods Forty six cases of thoraclumbar fracture spinal cord injuries were studied. All enous ihac grafting and fixation by K-plate cases were operated by anterior decompression, reduction, autogsystem. Based on which the advantages and disadvantages, indication, operative approaches and oprions of internal fixation were analyzed. Results All cases were followed up for 8 to 48 months with an average of 19 months. No complications occurred, such as breaking of the plate and screw. Among these cases, the height of fracture vertebra recovered 90% were 34 cases, 12 cases were recovered 80%. All the patients were recovered 1 to 3 Frankel grades, except 8 cases whose spinal function were A grade before operation. Conclusion The methad of anterior decompression and internal fixations is effetive approach with which the decompression, reduction, internal fixation, bone grafting, abnormality correction and reconstraction of spinal stability can be performed under direct vision at one stage. K-plate system is a good internal fixation system for the treatment of thoracolumbar fractures.