AF内固定系统治疗胸腰椎骨折132例临床观察

AF instrumentation for the treatment of unstable thoracolumbar fractures in 132 cases

目的综合评价AF椎弓根螺钉内固定系统治疗胸腰椎骨折的效果。方法回顾性分析132例应用AF经椎弓根内固定系统治疗的胸腰椎骨折患者手术前后的临床体征、X线片和CT。结果132例患者椎体前缘高度由术前58%恢复至97%,椎体后缘(中柱)高度由术前76%恢复至98.7%,Coob's角由术前平均19.1°恢复至术后1.8°,椎管内移位骨块复位率达90%。98例有神经损伤症状的患者术后获得10～19个月(平均14个月)随访,95例患者的神经功能有1～3级恢复,3例没有明显改善。结论AF椎弓根内固定系统能达到精确复位固定及椎管有效减压,是一种治疗胸腰椎骨折的有效方法。

Objective To comprehensively evaluate the clinical results treating patients with unstable throacolumbar fractures by AF（ atlas fixation system）. Methods A total of 132 cases of unstable thoracolumbar fractures were reviewed. All patients were treated by AF operation and evaluated with clinical sings, X - ray and CT before and after operation. Results Of 132 cases, anterior height of compressed vertebral bodies was restord from 58% preoperatively to 97% postoperatively,posterior height was from 76% to 98.7%. Cobb＇ s angle was corrected from 19.1 o preoperatively to 1.8°postoperatively. CT identified that the reduction rate of bone block that fratured and migrated into vertebral canal was 90%. Ninty - eight cases were followed up for an average of 14 months, 8 patients who had no change and others 95 cases progressed 1 -3 grade. Conclusion AF instrumentation can achieve anatomical reduction, decompression of spinal cord effectively and strengthen interior fixation. It is one of the best devices for the treatment of thoracolumbar fractures.