伴有脊髓神经损伤的脊柱胸腰段爆裂骨折的后路经椎弓根内固定术

Posterior segmental pedicular fixation in the treatment of thoracolumbar burst fractures with spinal cord injury

目的探讨伴有不全性脊髓神经损伤的脊柱胸腰段爆裂骨折的后路经椎弓根短节段固定、融合术的治疗效果。方法对36例伴有不全性脊髓神经损伤的脊柱胸腰段爆裂骨折患者行后路经椎弓根撑开复位、短节段内固定及后路植骨融合术，通过观察术后症状的改善及骨折复住情况来评估其疗效。结果所有患者随访获得10个月～4年（平均3年）的随访，所有患者椎体高度基本恢复正常，生理屈度矫正，脊髓神经损伤的恢复按Frankel评级均有1～3级的提高。结论经后路椎弓根撑开复住、短节段内固定及后路植骨融合术可以有效的治疗大多数伴有不全性脊髓神经损伤的脊柱胸腰段爆裂骨折。

Objective To investigate the effects of posterior reduction and fixation through pedicle along with spinal fusion in patients with thoracic or lumbar burst fractures and incomplete spinal cord injurys, Methods Posterior reductions/segmental pedieular fixations and spinal fusions were applied in 36 cases of thoracic or lumbar burst fractures combined with incomplete spinal cord injury. The clinical outcomes were evaluated through observations of symptomatic inprovernents and fracture corrections postopera- tively. Results All cases were followed up over a period of 10 months to 4 years （average 3 years）. Almost completely restoration of vertebral height and correction of kyphotic deformity were achieved, Neurological status was improved by 1-3 degrees accord- ing to Frankle classification. Conclusion Po,sterior reduction/segmental pedicular fixation and spinal fusion is a effective method in the treatment of most thoracolumbar burst fractures with incomplete spinal cord injurys.