非透视监控下椎弓根固定器治疗胸腰段爆裂性骨折

Treatment of thoracolumbar vertebral burst fracture using transvertebral pedicle fixation apparatus without roentgenoscopic monitoring

目的 探讨非透视监控条件下经椎弓根短节段内固定器的应用。方法 应用RF、SF、AF、DRFS经椎弓根短节段内固定器治疗胸腰段爆裂性骨折 51例 ,术中均无条件采用透视监控。结果全部病例伤椎定位准确 ,螺钉定位及进钉均一次正确完成。所有螺钉均位于椎体内 ,和椎体上终板基本保持平行 ,最大误差仅为 3°。Cobb s角由术前平均 2 7 8°恢复到平均 6 5°。椎体后缘高度由术前平均76 5 %恢复到平均 97 4 %。随访 46例 ,平均随访 1 9个月 ,Frankel脊髓神经损伤分级除 2例A级无恢复外 ,余均有 1级以上的恢复。结论 非透视监控条件下经椎弓根短节段内固定器的应用 ,必须具备全面系统的解剖知识和丰富的手术经验。否则 。

Objective To explore the clinical application of short section transpedicular fixation apparatus for the treatment of thoracolumbar fractures without roentgenoscopic monitoring Methods Fifty one patients with thoracolumbar vertebral burst fracture were treated with RF?SF?AF?DRFS short section transpedicular fixation apparatus without roentgenoscopic monitoring.Results In all patients,the involved vertebrae was accurately located;orientation of inserting screw point was correct;the screw insertion was successfully performed without further correction.All screws were located within pedicle and vertebrae.They were essentially parallel to the upper end plate,and the maximum deviation was only three degrees.The preoperative average Cobbs angles were 27 8 degrees,and the postoperative ones were 6 5 degrees.The preoperative height of the posterior vertebral body was 76 5%,and the postoperative height was 97 4%.Forty six cases were followed up for an average of 19 months.By Frankel grading on nerve injury,except 2 cases of grade A without recovery,all the other patients achieved recovery of above class one.Conclusion Knowledge on anatomy and rich operative experience must be possessed during utilizing this technique,otherwise,the technique should not be recommended.