经后路短节段融合治疗A3.1型胸腰段爆裂骨折

The Short Posterior Segment Fusion Treat A3.1 Chest-waist Burst Fracture

[目的]探讨经后路短节段融合治疗A3.1型胸腰段爆裂骨折的疗效。[方法]对2005年2月至2010年2月间38例胸腰段A3.1型骨折伴有脊髓神经损伤的患者,行后路椎弓根螺钉撑开、复位,上或下终板骨折相邻节段后外侧和经椎弓根椎体内植骨。1年后拆除内固定,对手术疗效进行总结和随访。[结果]随访1～5年,平均2年。后凸成角术前平均26°,术后5°,椎体前高术前平均丢失48%,术后恢复到94%。随访无椎体前高及后凸矫正角度丢失,38例神经功能2例A级除外,其余均有Frankel(2～3)级改善。[结论]该术式减少了融合节段,简单、安全、合理、疗效好,最大限度保留了脊柱的运动节段,减少了邻椎病,符合现代治疗理念。

[Objective ]To explore the cure effect of short posterior segment fusion on A3.1 chest-waist burst fracture. [Method[ To 38 cases of said patients, make posterior vertebral pedicle repostion, make bone graft in vertebra] pedicle. Remove the fixation after 1 year, make summary and follow-up to the operational effect. [Result] Follow up for average 2 years, the rear protruding angle was 26°before operation, and 5°after operation; the front vertebral protrusion lost 48% before operation, recovered to 94% after operation; 38 cases improved nerve function at Frankel（2-3） level. [Conclusion] The operation reduces fusion, simple, safe, reasonable, with good cure effect, largely preserving spinal sports function, decreasing neighboring vertebral disease, in accordance with modern therapy idea.