经皮空心椎弓根螺钉AF系统治疗胸腰椎骨折

Percutanuous fixation with cannulated AF system in the treatment of thorocolumbar fractures

目的探讨经皮空心椎弓根螺钉AF系统微创治疗胸腰椎骨折的疗效。方法对11例胸腰椎骨折患者采用后路经皮空心椎弓根螺钉AF系统内固定。切口为4个1.5cm长的小切口,椎弓根穿刺操作在透视引导下进行。结果 11例患者椎体高度恢复和后凸畸形纠正良好,伤椎高度由术前(65±13)%恢复至术后(92±7)%,局部后凸畸形自术前后凸19°恢复至术后6°。2例发生小切口皮缘坏死伤口延迟愈合,1例伤口积液,1例术后11个月出现内固定松动。随访24～36个月,期间未发现断钉断棒、后凸畸形加重、椎间隙高度丢失等并发症。结论该方法治疗胸腰椎骨折可恢复椎体高度,矫正后凸畸形,创伤小、手术时间短、出血少、恢复快。

Objective To introduce the technique of minimally invasive percutaneous fixation with cannulated AF system in the treatment of thoracolumbar fractures.Methods Pedicle screws of AF system were inserted percutaneously to treat 11 cases of thoracolumbar fractures under image intensifier.4 small incisions were cut but each of them was only 1.5 cm long.Results 11 cases got good restoration of vertebral body height and kyphosis deformity.The mean height of the fractured vertebrae was well restored from（65±13）% pre-opeation to（92±7）% post-operarion.The mean kyphosis degree was also corrected by the AF system from 19°pre-opeation to 6° post-operarion.2 cases had incision infection and healed 4 weeks after operation,1 case had effusion in the wound and 1case got pedicle screw loosening 11 months after the operation.No severe complications such as screw breakage,loss of the vertebral height,increase of kyphosis was found during postoperative follow up.Conclusions The technique of percutaneous canulated AF system is effective and it has the advantages of simple manipulation,safety,minimally invasive,less bleeding,and quickly recovery.