新型脊柱外固定器联合经皮椎体成形术治疗胸腰椎新鲜骨折

Treatment of Fresh Thoracolumbar Vertebral Fractures with Meliorative External Fixation Combined with Percutaneous Vertebroplasty

目的总结应用新型脊柱外固定器联合经皮椎体成形术（PVP）治疗胸腰椎体新鲜骨折的经验。方法采用经皮新型脊柱外固定器联合PVP技术治疗胸腰椎新鲜骨折病人16例，其中单纯椎体压缩型骨折9例，爆裂骨折7例。结果术后椎体高度明显恢复，椎体前缘高度由术前平均56％（15％～77％）恢复至术后89％（62％-100％）。脊柱后凸畸形角显著减小，脊柱后凸角由术前平均33．450（25^o～56^o）恢复至术后平均5．3^o（0^o～15^o）。术后15～30天拆除外固定，随访6～9月（平均7．6月），椎体高度无明显下降。5例有神经症状的患者，其神经损伤ASIA分级基本恢复到E级。结论新型脊柱外固定器联合PVP技术能有效恢复胸腰椎新鲜骨折的椎体高度，改善神经功能，防止临近节段椎间盘退变。

Objective To treat fresh thoracolumbar vertebral fractures with meliorative external fixation combined with percutaneous vertebmplasty and summarize the experience of clinical application. Methods 6 cases of thoracolumbar vertebral fracture patients were treated by meliorative external fixation combined with percutaneous vertebmplasty. There were 9 cases of vertebral compression fractures and 7 cases of vertebral burst fractures among the patients. Results The height of vertebral bodies were increased obviously. The degree of anterior height was increased from 56% （15% - 77%） before operation to 89% （62% - 100%） after operation. The angle of kyphosis was decreased from 33.45^o（25^o- 56^o} before operation to 5.3^o（0^o - 15^o） after operation. The external fixation was dismantled after 15 - 30 days. The height of vertebral bodies hadn＇t lost after 6 - 9 month（average 7.6 month） follow up. According to ASIA classification, 5 cases showing spinal cord or nerve roots injury symptoms improved to E degree. Conclusion The technology of meliorative external fixation combined with percutaneous vertebmplasty could increase the height of thoracolumbar vertebra with fracture, improve the function of nerve and avoid the decrease of disc close to the vertebra with fracture,