抗旋转复位内固定器治疗胸腰段椎体骨折

Experience on operative treatment of thoracolumbar fracture with paraplegia by ARRIF system

目的应用抗旋转复位内固定器(ARRIF)治疗胸腰段脊柱爆裂性骨折,观察其治疗效果及截瘫恢复情况。方法对28例胸腰段脊柱骨折进行切开复位内固定,从椎体复位效果及神经功能恢复情况等方面对ARRIF的临床效果进行观察。结果按Frankel神经功能分类:术前A级3例,B级2例,C级15例,D级7例,E级1例;术后神经功能分类:A级2例,B级3例,C级15例,D级7例,E级1例。ARRIF胸腰椎体复位情况:Cobb角术前为(21.3±8.1)°,术后为(4.0±3.6)°;伤椎高度术前为(56.4±11.7)%,术后为(92.1±7.2)%。全组术后均无神经功能障碍加重,未出现断钉、断杆等并发症。结论ARRIF能较好地对不同类型的胸腰段脊柱爆裂性骨折进行复位和固定,是一种有效的经椎弓根内固定器。

Objective To evaluate the effects of anti-rotation reduction internal fixator （ARRIF） on treating thoracolumbar spine burst fracture.Method The 28 patients with thoracolumbar fracture were operatively treated by ARRIF;incidence post operation,recovery of nerve function and effects of reduction fixation were observed.Result Classification according Frankel＇s grade：A grade 3 cases,B grade 2 cases, C grade 15 cases,D grade 7 cases, E grade 1 case.The nerve function showed one Frankel＇s grade improvement after operation were as follows：A grade 2 cases, 1 case had no nerve function changes,B grade 2 cases, C grade 15 cases, D grade 7cases,E grade 1 case. The reduction status of thoracolumobar fracture by ARRIF were following： in Cobb angle pre- operative,（21.3±8.1）^o vs postoperative,（4.0±3.6）^o; in damaged height pre-operative, （56.4±11.7）% vs postoperative （92.1±7.2）%.The nerve function damage had no aggravation in all the patients.ARRIF had no complications of the breakage of screws and rods.Conclusion ARRIF proves to be a valid internal fixator in reducing and fixing different thoracolumbar segment spine burst fracture.