Steffee钢板内固定治疗胸腰椎骨折脱位及腰椎滑脱

Treatment of thoracolumbar vertebral fracture and dislocation and lumbar spondylolisthesis with internal fixation system of Steffee's plate

目的探讨治疗胸腰椎骨折脱位及腰椎滑脱的最佳方法。方法应用Ｓｔｅｆｅｅ椎弓根螺钉钢板内固定系统治疗胸腰椎骨折脱位及腰椎滑脱３２例。手术行相应椎板切除减压、探查，采用在纵向对抗牵引脊柱的基础上垂直提拉椎弓根螺钉，拉顶复位相结合的方法复位。结果平均随访２６个月，复位满意，固定牢固，植骨均融合，平均脱位改善程度７４％。合并脊髓损伤的也有不同程度的恢复。结论Ｓｔｅｆｅｅ手术能使胸腰椎骨折脱位及腰椎滑脱的脊柱“三柱”贯通一体，固定牢固，有利于融合，固定范围小。

Objective To search for the best method in treating thoracolumbar fracture and dislocation and spondylolisthesis Methods 32 cases of thoracolumbar fracture and dislocation and lumbar spondylolisthesis were treated with Steffees operation. During the operation, lamina of vertebral arches was excised to reduce pressure under axial contertraction of the spinal column,the screw on vertebral arch was lifted vertically,and the vertebra was pressed with the hand Results The average follow up time was 26 months ,and the improvement on average was 74%. The cases complicated with spinal cord injury were also improved. Conclusion The three columns of thoracolumbar spine fracture and spondylolisthesis can be stabilized by Steffees operation,with a short range and stable internal fixation and without sacrifice of lumbar range of motion.