屈曲位撑开提拉复位法治疗伴有严重脱位的胸腰椎骨折

Opening and pulling under flexed position for thoracolumbar fracture accompanied serious dislocation

目的 探讨在屈曲位时利用椎弓根钉棒系统撑开提拉复位治疗伴有严重脱位的胸腰椎骨折的临床疗效.方法 对22例伴有严重脱位的胸腰椎骨折患者行手术治疗,随访12～ 18个月.按美国脊髓损伤学会（American Spinal Injury Association,ASIA）分级法评估手术前后的神经功能,测量并分析比较手术前后的Cobb角.结果 术后X线片显示所有患者脱位完全纠正;术后Cobb角由术前平均21°恢复至4°;15例神经功能有1～3级恢复.结论 利用椎弓根钉棒系统在屈曲位时撑开提拉复位治疗伴有严重脱位的胸腰椎骨折的临床疗效肯定,复位方法简易.

Objective To discuss the clinical curative of opening and pulling under flexed position by pedicle screw system for the treatment of thoracolumbar fracture accompanied serious dislocation.Methods A total of 22 case of thoracolumbar fracture accompanied serious dislocation were treated with this way.Nerve function was evaluated with American Spinal Injury Association （ASIA） classify.The Cobb＇s angle were measured before and after operation.Results All cases were completely corrected; The average Cobb＇ s angle was decreased from 21° preoperative to 4° postoperative.Fifteen cases＇ nerve function was restored more than 1-3 grade.Conclusion The clinical curative of opening and pulling under flexed position by pedicle screw system for the treatment of thoracolumbar fracture accompanied serious dislocation is certain,and this method is simple and easy.