椎弓根螺钉在胸腰椎骨折治疗中的应用

Application of pedicle screw in the treatment of thoracic lumbar vertebrate spinal fracture

目的介绍和总结椎弓根螺钉（PS）在胸腰椎骨折治疗中的应用经验及研究进展。方法应用PS治疗胸腰椎骨折21例。其中T10骨折2例，T11骨折3例，T12骨折5例，L1骨折5例，L2骨折3例，L3骨折2例，L4骨折1例。分离显露损伤椎体及上下各一个椎体行后路减压，椎弓根螺钉复位内固定，小关节突及横突间植骨融合。结果21例均获随访，时间6～18个月，骨折均愈合，19例椎体高度完全恢复，压缩性骨折中2例残留10％～30％的压缩未能恢复，20例植骨融合良好，无内固定松动现象。结论椎弓根是脊柱中最坚强的部位，椎弓根螺钉经椎弓根至椎体固定胸腰椎骨折操作简便、固定可靠、骨折复位和胸腰椎正常弧度可以分步骤一次完成，重建的脊椎稳定性好，可早期下床活动，为目前胸腰椎骨折治疗中较好的方法之一。

Objective To introduce and summarize experiences of application of PS in the treatment of thoracic lumbar spinal fracture. Methods Twenty-one of thoracic lumbar spinal fractures： T10 2 cases, T11 3 cases, T12 5 cases, L15 cases, L2 3 cases, L3 2 cases, L 4 1 case, were treated with posterior deeompres-sion and internal fixation and bone grafting with PS system. Results All cases were followed up for 6 -18months, complete fusion of bore graft and fractures were observed in all the cases without local paining and screw loosening and breaking. Conclusions PS system could supply in trinsic and good reconstructive spinal stability and easy operation and make patients get earlier out of bed activity, there fore PS system＇is a good posterior fixation system.