通用型脊柱内固定系统在相邻两节段胸腰椎骨折中的运用

Using general spine system in double-level continuous thoracolumbar fractures

目的探讨相邻两节段胸腰椎骨折致伤机制、生物力学特点及运用通用型脊柱内固定系统(GSS)的稳定性及固定效果。方法对2002年1月～2008年12月共17例相邻两节段胸腰椎骨折采用GSS治疗进行回顾性分析。结果 17例均获得随访,固定后后凸角、椎体前缘高度较术前均明显改善,原突入椎管内骨块均基本复位或去除;随访时间9～70个月,平均28个月,术后常规卧床6w,椎体高度及后凸角无明显丢失,内固定无松动、断裂。固定前不全瘫的患者中,Frankel分级改善1～3级。结论 GSS用于相邻两节段胸腰椎骨折的内固定,具有安装简便、省时、固定牢靠等优点,结合早期常规卧床可获得良好的复位效果和临床疗效。

Objective To study the injury mechanisms and biomechanical characteristics of double-level continuous thoracolumbar fractures,and to explore the stabile and fixed effectiveness of general spine system（GSS）.Methods 17 cases of double-level continuous thoracolumbar fractures admitted from January 2002 to December 2008 were treated with GSS and their clinical data were retrospectively analyzed.Results All patients were followed up for an average of 28 months（range from 9 to 70 months）and had a routine bed rest for 6 w.Compared with the preoperative vertebral deformity,the postoperative X-ray films indicated that the kyphotic angle and the height of vertebral anterior border were obviously improved after fixation with CSS.The bone blocks in vertebral canal were reset or dislodged.Neither loss of vertebral height and kyphotic angle,nor loosening and breakage of the pedicle screws occurred.The neural function in patients with paresis improved from 1 to 3 grades according to Frankel classification.Conclusion Using GSS in double-level continuous thoracolumbar fractures has many advantages such as convenient assemblage,saving time and firm fixation.Moreover,it can obtain good clinical therapeutic effects combined with early routine bed rest.