椎弓根钉内固定法治疗多节段胸腰椎骨折的临床效果观察

Observation of Vertebral Pedicle Screw Internal Fixation in the Treatment of Clinical Effect of Segmental Thoracic-lumbar Fracture

目的探讨椎弓根钉内固定法治疗多节段胸腰椎骨折的临床效果。方法我们选取于2008年3月至2011年11月入我院骨科治疗的多节段胸腰椎骨折患者45例为研究对象,对其采用椎弓根钉内固定方法治疗,恢复脊柱生理弯曲及伤椎高度、植骨融合,术后统计和分析手术取得的临床治疗效果。结果椎体高度及脊柱生理弧度术后得到了显著恢复。45例患者均获平均半年时间的随访,椎体高度无丢失,无断钉、及断棒。按Frankel分级:A级5例恢复至B级4例、无恢复者1例;B级7例恢复至C级4例、D级2例、无恢复1例;C级10例恢复至D级7例、E级3例;D级11例恢复至E级10例、1例无恢复;E级12例仍为E级。结论多节段胸腰椎骨折影响脊柱稳定性,椎弓根钉内固定法能够恢复脊柱稳定性及生理弧度,为改善神经功能提供条件。

Objective To investigate the clinical effect of pedicle screw fixation treatment of multiple segments of thoracolumbar fractures. Methods We selected into the hospital orthopedic treatment in March 2008 to November 2011 segment ofthoracolumbar fractures of 45 patients for the study of its pedicle screw fixation method of treatment, restoring physiological curvature of the spine statistics and analysis of the injured vertebral height, bone fusion surgery to obtain clinical effect. Results The vertebral height and spinal physiological curvature of the postoperative significant recovery. 45 patients were an average of six months follow-up times, vertebral height without breakage, no loss and no broken rods. Frankel classification： a level 5 patients recovered to b grade 4 eases, no recovery; b grade 7 patients recovered to c-Class four cases, d 2 patients did not recover one cases; c-Class and 10 eases returned to d 7 cases of grade 3 cases, e-class; d level 11 patients recovered to e 10 cases, 1 cases of recovery; 12 cases of e-class is still the e-class. Conclusion The multi-stage chest lumbar vertebra bone fracture influence spinal column stability, in the vertebral arch root nail the fixation method can restore the spinal column stability and the physiological radian, provides the condition for the improvement nerve function.