三及四对椎弓根螺钉内固定在脊柱损伤治疗中的研究

Three and four pairs of pedicle screw fixation in the treatment of spinal cord injury distribution significance

目的：探讨三及四对椎弓根螺钉内固定对脊柱损伤进行治疗的临床意义。方法对2011年8月～2012年7月收治的70例行后路椎弓根螺钉内固定手术患者作回顾性分析，根据骨折类型，将其分为爆裂骨折、压缩骨折、骨折脱位、多节段脊柱损伤。对骨折脱位和爆裂骨折患者行两节段椎弓根螺钉内固定，与三节段以上椎弓根螺钉内固定疗效作对比分析。结果两对椎弓根螺钉内固定患者术后有3例发生损伤处再次移位，行三及四对椎弓根螺钉内固定患者并未发生此现象。三及四对椎弓根螺钉内固定发生螺钉断裂、松动显著低于两对椎弓根螺钉内固定。结论有脊柱骨折位移患者，在损伤椎体中的上下椎体部位多采取两对椎弓根螺钉固定，可显著减少术后发生位移。三及四对椎弓根螺钉内固定，对脊柱损伤的治疗中，有着极为显著的意义，能减少螺钉松动和断裂情况，对脊柱稳定性维持极为重要。

Objective To investigate the clinical significance of three and four pairs of pedicle screw fixation for spinal injury treatment. Methods 70 cases of posterior pedicle screws were retrospectively analyzed, according to the type of fracture, which were divided into burst fracture, compression fracture,fracture and dislocation, multi segmental spinal injury. Fixation of fracture dislocation and burst fracture underwent two stages of pedicle screws,comparing with the effect of the above three segmental pedicle screw fixation.Results Two of pedicle screw fixation in patients after operation had 3 cases of injury once again shift, line three and four pairs of pedicle screw fixation in patients did not happen this phenomenon. Three and four pairs ofpedicle screw fixation screw fracture, loosening was significantly lower than that of pedicle screw fixation. Conclusion Patients with spinal fracture ofvertebral displacement, damaging in the upper and lower vertebral body which take two pairs of pedicle screw fixation, can significantly reduce postoperativedisplacement. Three and four pairs of pedicle screw fixation treated with spinal injury can reduce the screw loosening and fracture, and is very important to maintain spinal stability.