后路椎体次全切除并钛网支撑椎弓根钉棒系统内固定治疗胸腰椎爆裂骨折疗效观察

Posterior Subtotal Corpectomy and Spinal Reconstruction Using Titanium Mesh and Pedicle Screw for Treating the Burst Fracture of Thoracolumbar Vertebrae

目的探讨后路侧前方椎体次全切除减压并钛网植骨支撑、椎弓根钉棒系统内固定治疗胸腰椎爆裂性骨折的临床应用效果。方法对深圳市平乐骨伤科医院自2005年12月至2008年10月来采用后路经椎弓根侧前方减压,钛网植骨支撑,椎弓根钉棒系统内固定术的26例病进行随访分析。结果 26例均获随访10～12个月。手术后Cobb角矫正13°～26°,平均17°。神经功能恢复(Frankel分级):2例神经损伤Frankel A级患者神经功能未恢复;8例B级患者中2例未恢复,6例恢复至C级;10例C级患者中9例恢复至E级,1例恢复至D级;4例D级患者均恢复至E级。在随访期内,所有病例影像学指标:未出现不融合、钛网下沉及内固定松脱移位。结论后路经椎弓根椎体次全切除减压钛网植骨支撑,钉棒系统内固定术治疗胸腰椎爆裂性骨折可获得良好临床疗效。

Objective To investigate the effect of posterior subtotal corpectomy through the pedicle,titanium mesh support and pedicle screws system fixation in the treatment of burst fracture of thoracolumbar vertebrae.Method Twenty-six patients who suffered from the burst fracture of thoracolumbar vertebrae were treated with subtotal corpectomy through pedicle,titanium mesh supposing autograft and pedicle screws system fixation.Result The patients were followed up for 10 to 12 months.The Cobbs angle did not obviously lose.According to Frankel ading,2 of grade A had no obvious recovery.In 8 of grade B,2 had no obvious recovery,6 improved to C.In 10 of grade C,9improved to E,1 to D.4 cases of grade D improved to E.Conclusion There had good clinical curative effect with subtotal corpectomy through pedicle,titanium mesh supporting bone autograft and pedicle screws system fixation.