Dick内固定治疗胸腰段椎体骨折合并脊髓损伤

The use of Dick's fixation system for the treatment of thoraco lumbar vertebral fracture associated with spinal cord injury

目的 观察Dick内固定系统对胸腰段椎体骨折合并脊髓损伤的治疗效果。方法 对30例急性胸腰段椎体骨折合并脊髓损伤的病人施行后入路Dick内固定手术 ,对手术前后损伤椎体的高度、Cobb角及脊髓功能进行对比研究。结果 术后损伤椎体高度恢复均达 90 %以上 ,Cobb角均小于 10°。随访 3～ 48个月 (平均 10个月 ) ,椎体高度和Cobb角恢复无丢失 ,无椎弓根螺钉断裂现象。Frankel脊髓功能分级评定显示 :除 1例术前为A级者无恢复外 ,其余 2 9例均有不同程度的恢复。结论 后入路Dick内固定手术是治疗急性胸腰段椎体骨折合并脊髓损伤有效而可靠的方法 ,早期手术效果好。术后早期行床上功能锻炼 。

Objective To evaluate the therapeutical effect of Dick's fixation system on the treatment of thoraco lumbar vertebral fracture associated with spinal cord injury Method 30 cases of acute thoracolumbar vertebral fracture associated with spinal cord injury were treated with Dick's fixation system.The hight of the injured vertebrae,the cobb's angle and spinal cord function before and after operation were measured and a comparative analysis was conducted.Results The mean period of follow up was 10 months(from 3～48 months),all the hights of the injured vertebrae were restored by up to 90%,the cobb's angle were less than 10°,Frankel score of spinal cord function showed there were no obvious loss of the hights of the injured vertebrae,no increase of the cobb's angles,no break of screws and different degrees of spinal cord functional recovery in all patients except 1 who had a score of A before operation.Conclusion Dick's fixation system is an effective and reliable device for the treatment of acute thoraco lumbar vertebral fracture associated with spinal cord injury.Patients should be operated upon earlier for better effects.