前路减压椎体间融合联合Z-plate内固定治疗胸腰椎爆裂骨折疗效观察

Anterior Decompression Interbody Fusion with Z-plate Internal Fixation for Thoracolumbar Burst Fracture

目的探讨椎管前路减压椎体间融合联合Z-plate系统内固定治疗胸腰椎爆裂骨折的疗效。方法对我科2000—2004年收治的86例胸腰椎爆裂骨折伴脊髓损伤患者采用前路脊髓减压、植骨、Z-plate前路钢板内固定术,通过术前、术后影像学对比,了解椎间隙高度和植骨融合等情况,以美国脊髓损伤学会(ASIA)分级来评价患者神经功能恢复情况。结果75例不完全截瘫患者基本恢复正常,其中3例下肢肌轻度萎缩;11例完全截瘫患者截瘫平面有不同程度下降。所有患者术后X线片示椎体高度基本恢复。结论胸腰椎骨折行前路减压、植骨与Z-plate内固定,减压充分,植骨融合可靠,可很好地恢复椎体高度及脊柱的稳定性,有利于神经功能恢复。

Objective To study the clinical efficacy of thoracolumbar vertebral burst fracture treated by vertebral canal decompression and bone grafting combined with Z - plate spinal system internal fixation. Methods From 2000 to 2004, 86 inpatients with thoraeolumbar vertebral burst fracture were enrolled. All patients were treated with decompression of anterior vertebral canal, bone grafting and Z - plate spinal system internal fixation CT scanning before and after operation was conducted to investigate the decompression position of grafted bone and fusion, and the recovery of nerve function was evaluated with the standard of American Spinal Cord Injury Association （ASIA）. Results All the 75 patients with non - complete paraplegia recovered basically, of which 3 cases had muscle atrophy of the lower limbs. The other 11 cases of complete paraplegia recovered in different degrees at level of senses. The height of vertebral body in all patients recovered completely as showed by X - ray film after operation. Conclusion Surgical treatment of thoracolumbar fracture by anterior decompression, bone grafting, Z - plate system internal fixation can provide sufficient decompression, high rate of fusion of the implanted bone, good recovery of vertebral body height and stability in the spine, being conductive to recovery of neurological function.