伤椎固定在严重胸腰椎骨折中的应用

Application of injured vertebrae fixation in severe thoracolumbar fracture

目的探讨在严重胸腰椎骨折中应用短节段椎弓根螺钉系统加伤椎固定的方法和效果。方法回顾了我院2003年5月-2008年1月,对严重胸腰椎骨折采用短节段椎弓根螺钉系统加伤椎固定方法治疗41例。术前骨折椎体前缘高度平均丢失53%（37%-82%）,Cobb角平均29.6°（17°-39°）,均在伤后2周内手术。结果所有病例均获得随访,平均随访时间9.7个月（6-29个月）。影像学资料显示伤椎前缘高度恢复至92%（87%-96%）,术后Cobb角平均为5.6°（3°-10°）,植骨均愈合、椎体脱位纠正,复位良好。结论对严重胸腰椎骨折应用伤椎椎弓根螺钉固定可以增强后路短节段内固定系统的牢固性,有利于维持矫正效果、减少后凸畸形。

Objective To discuss the validity and effectiveness of short level pedicle screw complex plus injured vertebrae fixation in severe thoracolumbar fracture. Methods 41 patients who suffered from thoracolumbar fracture and had been treated with short level pedicle screw complex plus injured vertebrae fixation were retrospect. The mean reduction of vertebrae height in anterior edge was 53% （from 37%-82%）. The mean degree of Cobb’s angle was 29.6 （from 17 degree -39 degree）. Operation had been conducted in 2 weeks after fracture. Results All cases were followed up. Mean follow-up period was 9.7 months （from 6 months to 29 months）. The radiographs showed that anterior edge of injured vertebrae restored to 92% （from 87% to 96%）, and the mean Cobb＇s angle was 5.6 degree （from 3 degree to 10 degree）. The dislocation of vertebrae was corrected and fusion was completed. Conclusion Application of short level pedicle screw complex plus injured vertebrae fixation in severe thoracolumbar fracture can enhance the strength of posterior instrumentation. It is in favor of correcting the kyphosis deformity.