钉棒固定并前路减压植骨治疗胸腰段脊柱骨折

Thoracolumbar fractures treated by nail internal fixation and Anterior decompression bone graft

目的经前路应用中华长城钉棒系统固定并前路减压植骨融合治疗胸腰段脊柱骨折,前瞻性地研究其内固定治疗的作用及价值。方法采用经胸膜外或腹膜后入路,对18例胸腰段骨折行前路中华长城钉棒系统撑开复位固定,前路彻底减压,取肋骨或髂骨椎间植骨。结果18例胸腰段脊柱骨折患者手术均获9个月～24个月随访,平均12.7个月。椎间植骨均获成功。随访期间未见后凸畸形复发或加重,神经功能获1级以上恢复者达92.3%.有1例发生了断钉,幸未造成副损伤。结论经前路手术减压直接彻底,可获得神经功能最大改善。中华长城钉棒系统设计科学合理,操作简便,内固定材料由钛合金制造,生物相容性好,不必二次取出,是治疗胸腰段脊柱骨折一种可靠有效的方法。

Objective To prospective study the value and effection of Nial （Greatwall,China） system by anterior decompression, internal fixation and fusion for treatment of thoracolumbar fracture.Methods Through the way of inletting from the outside of the thoracico-abdominal or from the back of peritoneum, 18 cases of thoracolumbar fractures treated with nail system and anterior decompression,internal fixation and fusion. It was completely decompressed from anterior, implanting costal part or iliac bone intervertebral. Results All the 18 cases had been followed up for 9 to 24 months, 12.7 months on average. Implanting iliac bone intervertebral were successful for all eases. There was no relapse of post deformity. 92.3% of eases got the first class recovery on the nerves .One of the cases got the pin broken,luckily there was no nagative damage. Conclusion Anterior decompression is a direct and complete method and can greatly improve the function of the nerves. The nail system of great wall China is designed scientifically, easy to operate, made with titanium alloy which has better biological fusion. It does not need to be taken out for the second time. It is a reliable and effective way to cure thoracolumbar fractures.