前路减压内固定术治疗胸腰椎骨折并截瘫

Treatment of fractures of thoracolumbar vertebral body with paraplegia by anterior route decompression and internal fixation

目的探讨前路减压、植骨融合及Kaneda、Z-Plate钢板内固定术在治疗胸腰椎骨折并截瘫中的疗效。方法对51例胸腰椎骨折患者行前路减压、植骨及内固定术,其中,采用Kaneda内固定32例,Z-Plate钢板内固定19例。结果术后随访5个月～8年,其中45例获良好复位,脊柱生理曲线恢复。48例神经功能恢复按Frankel分级提高1～3级。结论Kaneda内固定系统具有前路减压彻底、内固定牢靠及价格便宜等优点,而Z-Plate钢板内固定具有操作简单、稳定性强、合并症少、生物相容性好等特点。

Objective To study the clinical outcome of thoracolumbar fractures treated by ante rior route decompression,bone-graft-fusion and internal fixation.Methods 51cases of thoracolumbar fractures from Jun1994to Mar 2002were treated by anterior route decompression,bone-graft-fusion and internal fixation,of w hich32cases by Kaneda system and 19cases by Z-Plate system.Their clinical data were analyzed.Results The patients were followed up from five months to eight years(average of 3.5years).45cases had a good anatomic reduction and maintain thoracic-lu mbar lordosis.48cases gained one to three Frankel grades of neurologic r e-covery as a consequence of operation.Conclusion Kaneda internal fixation has the characteristics of low cost,neurological decompression and reliable fixation;and Z-Plate systems has the advantages of simple manipul ation,intrinsic stability,less complications and good biocompatibility.