椎弓根钉内固定治疗多节段复杂胸腰椎骨折

PEDICLE SCREW FIXATION FOR COMPLEX MULTI-SEGMENT THORACOLUMBAR FRACTURES

目的探讨胸腰椎多节段复杂骨折手术治疗方式。方法采用后路长节段椎弓根钉系统复位固定方法,恢复伤椎高度及脊柱生理弯曲,使后纵韧带复张,椎管间接减压或有限椎板切除减压、植骨融合治疗胸腰椎多节段骨折共21例。观察治疗效果并随访。结果术后椎体高度、脊柱生理弧度明显恢复,经3个月~6年随访,复位后椎体高度无明显丢失,无断钉、断棒,Frankel分级获1~3级恢复。结论多节段胸腰椎骨折影响脊柱稳定性,后路长节段椎弓根钉系统复位固定能够恢复脊柱稳定性及生理弧度,为改善神经功能提供条件。

Objective To explore the operative treatment of multiple thoracic and lumbar segments of complex fracture.Methods Long-segment posterior pedicle screw fixation was used to restore vertebral height and spinal physiological bending to get the restoration of posterior longitudinal ligament,the indirect spinal canal decompression or limited laminectomy,and the thoracic fusion for multiple lumbar fractures in 21 cases.Clinical observation and follow-up surveys were conducted.Results The vertebral height and the spinal curvature got apparent physiological recovery according to the 3 months to 6 years of follow-up surveys,with no significant reduction of vertebral body height loss or broken nails or broken stick,and the Frankel grade revealed 1 to 3 recovery was got.Conclusion Segmental thoracolumbar spinal fractures may cause unstable spine fractures,and the method of long-segment posterior pedicle screw fixation can be used to restore spinal stability and physiological curvature to provide the conditions for the improvement of neurological function.