Dick钉对脊椎爆裂型骨折椎管的间接减压作用

Effect of Dick screw in indirect spinal canal decompression on burst fractures

目的 评估Dick 钉治疗脊椎爆裂型骨折对椎管的间接减压作用。方法 采用Dick 钉治疗44 例脊柱胸腰段(T12 ～L2) 爆裂型骨折患者,其中35 例使用CT 作术前及随访时骨折椎椎管前后径测量,计算间接减压的百分比。结果 术前平均椎管入侵40-8 % ,随访时为25-3 % ,平均间接减压15-5 % 。44 例中无迟发性脊髓神经受压发生。结论 后路间接减压效果与骨折椎平面、类型、手术时间早晚及手术医生的经验密切相关。

Objective To evaluate the effect of indirect spinal canal decompression in burst fractures treated with Dick screw. Methods 44 cases of thoracolumbar(T 12 ～L 2) burst fractures were treated by Dick screw. The anteroposterior diameters of the injured spinal canals were measured by CT in 35 cases. The percentage of the indirect decompression was calculated. Results The mean spinal canal encroachment was 40 8% before operation and 25 3% at follow up. The mean indirect decompression was 15 5%. Late spinal cord compression did not occur among 44 cases. Conclusion The effect of posterior indirect decompression is closely correlated with the fracture level, fracture type, timing of surgery and the surgeons experience.