可调式中空人工椎体治疗脊柱严重粉碎性骨折(附9例报告)

The Application of Adjustable Hollow Titanium Artificial Vertebral Body in Treating the Severe Burst Fracture of Spine

目的 探讨可调式人工椎体治疗椎体严重粉碎性骨折的临床效果。方法 1997年 3月～ 2 0 0 1年 12月间 ,用可调式中空钛合金人工椎体 (AHT -AVB)治疗脊柱严重粉碎性骨折患者 9例 ,T12 椎体粉碎性骨折伴截瘫 2例 ,L1椎体粉碎性骨折伴截瘫 2例 ,T12 椎体陈旧性压缩骨折伴马尾综合征 2例 ,颈椎骨折伴脱位 3例。植骨来源为自体骨 /自体骨 +Osteoset人工骨。观察患者手术时间、输血量、手术前后椎节高度、椎节间夹角以及人工椎体稳定性及融合情况等。结果 本组病例全部获得随访 ,随访时间 8～ 30个月 ,平均 18个月。术后椎节高度基本恢复正常。术后 3个月Osteoset人工骨大部份已吸收 ,椎间隙可见骨融合征象 ,术后 12个月时大多数已形成骨性融合。人工椎体无脱落或移位。神经功能改善 8例 ,无变化 1例 ,无明显并发症出现 ;结论 对严重粉碎的椎体骨折 ,无法行自体骨重建者 ,人工椎体不失为一种选择 。

Objective To observe the clinical effect of adjustable hollow Titanium artificial vertebral body in treating the severe spinal burst fracture.Methods From March 1997 to December 2001,9 cases of severe burst fracture of spine were treated with AHT-AVB.Diagnosis were 2 of T 12 burst fracture companied by paraplegia,2 of L 1 burst fracture companied by paraplegia,two T 12 old fractures companied by caudal equine syndrome and three cervical fracture and dislocations.The height and intervertebral body angle of the injured vertebral body were measured and as well as operation time and amount of bleeding during operation were recorded.Results Eight to thirty months with an average 18 months follow-up showed the height of spinal segment restored to normal after operation,bone fusion were occurred in most cases after 3 months.No migration of AVB was found in this group and neurofuntion were improved in 8 of 9 cases.Conclusion AHT-AVB can be used in the severe burst fracture of spine that is that is unable to use the auto graft as long as the indication was carefully followed.