椎弓根钉系统固定治疗胸腰段椎体骨折50例分析

Analysis of Treatment of 50 Cases Thoracolumbar Fracture with Pedicle Internal Fixation Instrument

目的评价椎弓根内固定系统治疗胸腰段骨折的临床疗效。方法对50例胸腰段骨折患者行后路切开复位椎弓根钉系统内固定术,对椎管变形和脊髓神经根受压则行减压。骨折节段分布在T11～L3。观察术后骨折复位及神经功能恢复情况。结果 50例患者随访时间3个月～3年,平均18个月,无断钉、断棒;伤椎前、后高度及脊柱后凸角度(Cobb角)均较术前有显著改善;神经功能按Frankd分级评定,除7例A级患者神经功能无恢复,其余神经功能均有1～3级的恢复。椎体骨折均顺利愈合,神经系统症状大部恢复。结论椎弓根内固定系统是治疗胸腰段椎体骨折安全有效的方法。

Objective Evaluate the clinical efficacy of pedicle internal fixation system in the treatment of thoracolumbar fractures.Methods？Fifty patients with thoracolumbar fractures were treated by open reduction and fixation operation with pedicle instrumentation through posterior approach.The fracture located at T11～L3.Postoperative fracture reduction and recovery of neurological function were observed.Results？Follow-up periods of 50 cases varied from 3 to 36 months and the average time was 18 months.No broken nails,broken rods;injured vertebra before and after the height and kyphosis angle（Cobb angle） was significantly higher than improved preoperative.By Frankd grades of neurological function,in addition to A-7 patients did not recover neurological function,and the remaining were grade 1-3 neurological recovery.All fractures healed successfully and thesymptom of nerve system recovered partially.Conclusion？Pedicle screws fixation for the treatment of unstable thoracolumbar fractures has high curative rate,reliable fixation,low cost and is useful for primary hospitals.