后路减压经椎弓根系统内固定治疗胸腰椎爆裂性骨折27例分析

Therapeutic effects of posterior decompression and fixation through pedicle in treatment of thoracolumbar burst fractures

目的探讨后路经椎弓根手术治疗胸腰椎爆裂性骨折的疗效。方法2004年6月至2006年9月，行经椎弓根减压内固定植骨治疗27例胸腰椎爆裂性骨折。其中，男20例，女7例；年龄18～65岁，平均41．7岁；Frankel分级：A级2例，B级2例，c级4例，D级9例，E级10例。行椎弓根螺钉内固定及植骨，椎管受压明显并有神经损伤者同时行经椎弓根减压。结果27例患者均获得随访，时间为6～24个月，平均11．8个月。Frankel分级：A级1例，B级1例，C级2例，D级7例，E级16例。术后摄片示减压充分，后凸畸形纠正。结论在严格掌握手术指征的情况下，经椎弓根减压内固定是一种安全有效的治疗胸腰椎爆裂性骨折的方法。

Objective To evaluate the clinical and radiographic outcomes of posterior decompression and fixation through pedicle in the patients with thoracic or lumbar burst fractures. Methods A retrospective study was made in 27 cases of thoracic or lumbar burst fractures from June,2004 to September,2006. Results All cases were followed up over a period of half to 2 years （average 11.8 months）. Neurological status was improved to Frankle B in 1 case,C in 2 cases,D in 7 cases,and E in 16 cases. Complete de- compression of spinal canal and correction of kyphosis were observed postoperatively by CT and X-ray after surgery. Conclusion Posterior decompression and fixation through pedicle is a safe and effective method in the treatment of thoracolumbar burst fractures.