胸腰椎爆裂性骨折前路Z-plate和U-front内固定的对比研究

Comparative Study of Z-plate System and U-front System of Anterior Approach for Treatment of Thoracolumbar Burst Fractures

目的回顾性比较前路减压植骨Z-plate和U-front脊柱内固定系统治疗胸腰椎爆裂性骨折的疗效。方法对自2004年3月～2009年10月收治的48例胸腰椎爆裂性骨折分别应用Z-plate脊柱内固定系统(Z组)和U-front脊柱内固定系统(U组)治疗各24例。结果本组获8个月～2年的随访。椎体前缘高度:Z组由术前(13.4±2.4)mm提高到术后末次随访(22.0±2.5)mm,U组由术前(12.9±2.6)mm提高到术后末次随访(22.5±2.3)mm,无论Z组或U组,术前与术后及末次随访的Cobb角、椎体前缘高度差异均有统计学意义(P<0.05),椎体后缘高度差异无统计学意义(P>0.05);所有患者神经功能均有1～3级的恢复。结论胸腰椎爆裂性骨折采用前路减压植骨Z-plate和U-front脊柱内固定系统治疗,均安全、可靠。

Objective To evaluate and compare the outcomes of Z-plate system and U-front system of anterior approach for the treat- ment of thoracolumbar burst fractures. Methods A total of 48 patients who undergong anterior approach for the treatment of thoracolumbar burst fractures were retrospectively analyzed from March 2004 to December 2009. They were divided into 2 groups according to 2 kinds of internal fixations：Z-plate system and U-front system, and each 24 patients. Results All patients were followed up for 8 months to 2 years. The vertebral body anterior height improved from （13.4±2.4）mm to （22.0±2.5）mm in Z-plate group and （12.9±2.6）mm to （22.5±2.3）mm in U-front group. There were significant differences in Cobh＇s corner and the vertebral body anterior height before and after operation between the two groups （P 〈0.05）. No significant difference was found in the vertebral body posterior height （P 〉0.05）. Neurologic deficits had an improvement by at least one modified Frankel grade. Conclusion The anterior spinal instrumentation and reconstruction techniques with Z-plate system and U-front system are securities and insurances for treatment of thoracolumbar burst fractures.