椎弓根钉系统与椎间融合器联合应用治疗下腰椎骨折脱位

The application of transpedicle instrumentation combined with interbody cages for fracture and dislocation of lower lumbar spine

目的 评价椎弓根钉系统联合椎间融合器在腰椎后路减压椎间植骨融合术 (PLIF)临床应用的效果及其生物力学特性。 方法 19例下腰椎骨折病人损伤部位为L3 ～L5,均有不同程度前后脱位。分别联合使用短节段椎弓根钉系统和椎间融合器 (Cage)进行治疗 ,并总结其临床资料 ,分析内固定的力学特点。 结果 19例中 ,17例获 3～ 2 0个月随访 ,内固定牢靠 ,骨融合率达10 0 %,神经缺失症状均有不同程度的改善 ,内固定本身无明显并发症发生 ,疗效满意。 结论 在后路减压椎间融合术中联合应用椎弓根钉系统和Cage装置 ,既能提供解剖复位及坚强内固定 ,又能增加植骨融合率 。

Objective To evaluate the clinical efficacy and biomechanical characteristics of transpedicle instrumentation combined with interbody cages for the fracture and dislocation of lower lumbar spine. Methods Nineteen cases with fracture and dislocation of lower lumbar spine were treated with segmental pedicle based plate combined with BAK or TFC implant, the clinical information was summarized and the biomechanical characteristics were analyzed. Results Seventeen cases were followed up for 3 20 months. The treatment efficacy was clinically satisfied, the fusion rate increased and no complication occurred. Conclusions The results indicate that the transpedicle instrumentation combined with interbody cages, such as BAK and TFC, has the advantage of strong fixation and high bone fusion rate in PLIF. This system is especially adapted to the traumatic unstableness of low lumbar.