不同装置前路重建胸腰椎的探讨

EXPLORATION OF RECONSTRUCTING ANTERIOR THORACO LUMBAR SPINE WITH DIFFERENT DEVICE

目的：探讨不同装置前路重建胸腰椎的效果，以选择适合病情的手术内固定装置。方法：对１９例胸腰椎肿瘤、结核、骨折患者，分别应用椎体钉５例，Ｋａｎｅｄａ器械８例，可调式人工椎体６例，一期切除病损椎体同时重建胸腰椎。结果：术后随访１５例，平均３７个月，术前Ｃｏｂｂ氏角平均２３度；术后Ｃｏｂｂ氏角平均１１度。术前椎体压缩平均６０％；术后椎体高度基本正常。１１例椎体间骨性愈合，２例植骨不愈合，２例植骨块吸收。神经功能除２例Ａ级无恢复外，其余均有Ｆｒａｎｋｅｌ２级以上恢复。结论：在直视下一期切除病损椎体同时重建胸腰椎具有减压彻底，内固定坚强，缩短卧床时间等优点。

Objective:To explore the effect of reconstructing anterior thoraco lumbar spine with different devices,soas to select internal fixators compatible with patients condition Methods:19 cases of tumor,tuberculosis,fracture of the thoraco lumbar spine were treated by applicating Dual Blade plate 5,Kaneda device 8,regulatable artificial vertebra 6 respectively Results:15 cases were followed up with an average period of 37 months,Cobb's angle of pre operation was averagely 23 degree Cobb's angle was averagely 11 degree after operation Compressing vertebar body was 60% in the pre operation The vertebar body height recovered to normal in the postoperation 11 cases gained the bone healing There were two cases of non union The implant bones were absorbed in two cases All patients except two with neurological involvement had improvement at least two grade on Frankel's scale Conclusion:Anterior decompression of fracture fragment or tumor resection followed by anterior reconstruction of thoraco lumbar spine has the advantages of direct vision operation,complete decompression,strong internal fixation,shortening the time of lyingin in bed