短节段C-D棒椎弓根螺钉治疗胸腰椎骨折疗效分析

Analysis of clinical evaluation in treatment or thoracolumbar fracture with short segmental C-D rod aud spinal pedicle screw

目的：探讨短节段Ｃ－Ｄ棒椎弓根螺钉治疗胸应椎骨折的临床意义．方法：采用短节段Ｃ－Ｄ棒折弯后对抗脊柱后凸畸形，产生过伸、撑开复位内固定，同时开窗减压和植骨。结果：完成６１例，随访1～６年，平均３．５年。术前椎体前、后缘平均高度分别为５０．８％和７２．１％，术后一周分别为９３．７％和９８．２％，术后一年分别为８９．７％和９２．３％。ｃｏｂｂ角术前平均２３．６°，术后平均６°，腰椎生理前凸术后平均１８°．结论：Ｃ－Ｄ系统结构简单，操作方便，固定牢固，使三柱产生均匀的前凸撑开，降低了前、中柱对螺钉的压缩负荷，防止椎体高度的远期丢失．对突入椎管内的骨折块及伤椎高度的矫正满意。

Objective: Study of clinical Significance in treatment of thoracolumbar fracture with short segmental C -D rod and spinal pedicle screw. Methods:Using C-D rod bent to arch,making the arch rod aganist kyphosis defor- mity of thoracolumbar fracture that osteoclastic reduction and internal fixation take place. Meanwhile fenestration re- ducing pressure for spinal canal and bone grafts were adopted. Results: Sixty-one cases were followed-up for one to six years and average 3. 5years. The front and back heigbt of vertebral body were average 50. 8% and 72. 1% repec- tively before operation,one week after operation the average beight is 93. 7 and 98. 2%,one year after operation the average is 89. 7% and 92. 3%. The cobb's angle was returned from preoperative 23. 6 degrees to postoperative 6 de- grees. Conclusions: The C-D system is simple in structure,easy to operate and solid of fixation. It provided symmet- ric three-column lordosis distraction,reduced the pressure load to the screw frem the front and midle columns, pro- vided against the loss of teh vertebral height in the long term after operation. It is satisfactory which corrected the fracture blocks entered into the spinal canal and vertebral height.