后路短节段固定联合伤椎置钉在胸腰段脊柱骨折中的应用

Application of posterior short-segment fixation combined with intermediate screws in fresh thoracolumbar compressed fracture：short-term outcomes in 27 cases

目的观察后路短节段内固定联合伤椎置钉在胸腰段脊柱骨折中应用的短期疗效。方法对27例胸腰段椎体骨折患者采用后路短节段内固定联合伤椎置钉的手术方法进行治疗，对患者术前术后的X线片进行测量，测量其伤椎高度恢复的比例以及后凸角度的纠正情况。结果术前骨折椎体高度（57．6±16．5）％，节段后凸角度（20．8±9．4）°；术后骨折椎体高度（93．8±11．9）％，节段后凸角度（5．9±7．4）°。手术前后骨折椎体高度和节段后凸角度差异均有统计学意义（均P〈0．001）。结论有条件地应用伤椎置钉技术有利于后路术中复位以及纠正后凸畸形，并且增加了内固定系统的强度。

Objective To observe the short-term outcomes of the application of posterior shortsegment fixation combined with intermediate screws in fresh thoracolumbar fracture. Methods Posterior short-segment fixation combined with intermediate screws was used in 27 patients suffering from fresh thoracolumbar fracture, 19 males and 8 females, aged 45 （22 - 71 ）. X-ray photography was conducted before and after operation. Results The height of fractured vertebra was 57.6% ± 16. 5% of the normal value before operation, and was restored to 93.8% ± 11.9% after operation; the segmental kyphosis angle on the sagittal plane was 20.8 ± 9.4% before operation, and decr5eased to 5.9 ± 7.4% after operation （ both P 〈 0. 001 ）. Conclusion Using pedicle screws on the fractured vertebra via posterior approach conditionally helps reduce the fractured vertebra and correct the kyphosis, and enhance the stiffness of the internal fixation system as well.