C-D器械固定加选择性椎间或椎体内植骨治疗不稳定性胸腰椎骨折

Cotrel Dubousset instrumentation and selective intrabody or interbody bone graft for unstable thoracolumbar fracture

目的改进治疗不稳定性胸腰椎骨折的治疗方法。方法应用经椎弓根固定器械（Ｃ－Ｄ）固定，加选择性椎间或椎体内植骨，治疗不稳定性胸腰椎骨折８２例。结果术后７８例达到解剖复位，３例大部复位，１例严重压缩性骨折，压缩的椎体虽未复原，但恢复了正常的脊柱力线。不全瘫者２８例术后均有不同程度的功能恢复，但完全截瘫者１７例功能无恢复。３５例经１～３年随访，畸形矫正满意，无矫正角度丢失，取钉后腰背僵硬感消失。结论该术式复位、固定可靠，不需另取髂骨，创伤小，可最大限度保留未损伤运动节段功能。

Objective To improve the method of treating unstable fractures in thoracolumbar spine. Methods 82 cases of unstable fractures in thoracolumbar spine were treated with Cotrel Dubousset(C D) instrumentations, combined with selective interbody or intrabody bone graft. Results The postoperative results showed that 78 patients obtained anatomical reduction; 3 cases were reduced generally; in one patient, whose seriously compressed vertebra was not reduced, but its spinal force line recovered. 28 cases of incomplete paralysis recovered to a certain degree after operation, but in 17 cases of complete paralysis,their functions did not recover. 35 cases were followed up ranging from 1￣3 years, the corrective result of deformity was satisfactory, no loss of corrective angle was found, and the stiff sensation disappeared after removal of the implant. Conclusion The C D instrumentation is reliable in reduction and fixation, there is only small trauma since this method needs no iliac bone for graft and it can reserve the functions of intact segments maximally.