经椎弓根螺钉内固定治疗胸腰椎骨折的临床探讨

Clinical study about the treatment of thoracolumbar vertebral fracture by internal fixation operation through pedicle of vertebral arch

目的:探讨和分析经椎弓根内固定系统治疗胸腰椎骨折的临床作用及疗效。方法:48例胸腰椎骨折后路椎弓根内固定,需椎管内减压者行半椎板或全椎板切除减压,随访18～30个月。结果:所有患者术后伤椎高度恢复,Cobb角改善,随访中未见椎体高度丢失和Cobb角改变;38例脊髓损伤患者36例Franke1分级获得不同程度提高,2例神经功能无改善者均为Franke1A级且入院时间晚。结论:在把握手术时机与适应症的前提下,后路椎弓根内固定手术可有效恢复椎体高度,重建脊柱稳定,改善脊髓神经功能。

Objective：To explore the effects of the treatment by internal fixation operation through pedicle of vertebral arch for thoracolumbar vertebral fracture cases. Methods：48 cases sufering from thoracic or lumbar vertebral fracture accept the treatment by internal fixation operation through pedicle of vertebral arch and intervertebral body fusion. Total or partly resection of vertebral plate was performed while needed for decompression.The lasted 18 ~ 30 months or more. Resldts：All the injured vertebrae had get repesition of height and the Cobb angle get well without any serious complication. Follow-up shows that every patient has get solid fusion with good height and stability,and the Cobb angle stain well. Thirty-six of the 38 spinal injury patients have get Frankel grade raise in different degree.There were 2 FrankelA grade spinal injury cases with no neuro-function amelioration,who both got late hospital admission. Conclusion：For thoracolumbar vertebral fracture,internal fixation operation through pedicle of vertebral arch and intervertebral body fusion provide repesition of the injured vertebra height and spinal stabilization,and the spinal nerves function will get improved,and the operation indication and opportunity must be assurance.