短节段通用脊柱系统内固定加伤椎内植骨治疗胸腰椎不稳定骨折

Treatment of thoracolumbar fractures with short segmental fixation using Universal Spine System

目的探讨应用短节段通用脊柱系统(USS)骨折内固定术及伤椎内植骨治疗胸腰椎不稳定骨折的临床疗效。方法对40例急性单节段胸腰椎不稳定骨折行后路短节段USS骨折内固定术及伤椎内植骨,对患者手术前后的椎体高度、Cobb’s角进行比较,观察术后1年内固定材料有无松动、断裂,椎体内及椎板间植骨融合情况,神经功能恢复情况。结果 40例患者术后1周、1年伤椎前后缘高度比值、Cobb’s角较术前均明显改善,差异有统计学意义(P<0.05),术后1周与1年上述指标比较差异均无统计学意义(P>0.05),术后1年未见内固定材料松动、断裂,椎体内及椎板间植骨均骨性融合,有5例神经功能较术前好转。结论短节段USS骨折内固定术及伤椎内植骨治疗胸腰椎不稳定骨折,椎体内及椎板间植骨融合率高,能有效防止术后矫正角度丢失及内固定失败。

Objective To evaluate the clinical effect of the method in treatment of thoracolumbar unstable fractures with posterior short-segment Universal Spine System{ USS） and vertebral bone graft. Methods Totally 40 cases of acute and single segmental thoracolumbar unstable fracture were treated by using posterior short-segment USS and vertebral bone graft,then the vertebral height and Cobb angle were compared pre-operatively and post-oper- atively. The conditions of fixed material, fusion, and recovery of neurological function were observed within 1 year postoperatively. Results The vertebral height and Cobb＇ s angle improved obviously after operation, and the data showed no statistical significance between 1 week and 1 year postoperatively. Postoperative follow-up showed that no material loosening, no breakage within one year. Bone fusion was achieved in the vertebra body and between the ver- tebral plates. Neurological function was recovered in 5 cases. Conclusion In the treatment of thoracolumbar un- stable fractures,the method of posterior short-segment USS and bone graft can obtain excellent fusion, maintain the correction effect and prevent internal fixation failure.