前路钉棒内固定治疗胸腰椎陈旧性爆裂骨折15例分析

Analysis of anterior screw-rod internal fixation system in the treatment of 15 cases suffered thoracolumbar old burst vertebral fracture

目的：探讨前路减压植骨重建及钉棒内固定系统治疗陈旧性胸腰椎爆裂骨折的临床疗效。方法：选择15例胸腰椎陈旧性爆裂骨折,采用侧前方椎体次全切除减压、钛网支撑植骨融合和前路钉棒内固定系统固定术治疗。结果：15例患者随访时间12~39个月,平均22.6个月。术前脊柱矢状位后凸Cobb角为14.8°±2.4°（6°~36°）,术后2周后凸Cobb角为4.5°±0.8°（-2°~8°）,与术前比较差异有统计学意义（P〈0.01）;术前局限性腰痛视觉模拟评分法（visual analogue scale,VAS）评分为5~9分,平均（7.2±1.3）分,术后2周VAS评分1~3分,平均（2.2±0.3）分,与术前比较差异有统计学意义（P〈0.01）。所有病例无严重手术并发症发生。结论：前路减压植骨重建及钉棒固定更有利于神经减压及重建脊柱稳定,是治疗陈旧性胸腰椎爆裂骨折的有效方法。

Objective： To analyze surgical effect of anterior screw-rod internal fixation system for treating thoracolumbar old burst vertebral fracture retrospectively. Methods： 15 patients suffered thoracolumbar old burst vertebral fracture were underwent lateral anterior corpectomy decompression,Titanium mesh bone fusion and anterior screw-rod internal fixation system treatment. Results： The patients were followed-up from 12 months to 39 months with an average of 22.6 month. Pre-operative Cobb angel was 14.8°±2.4°（arrange from 6°-36°）and post-operative 2 weeks Cobb angle was 4.5°±0.8°（arrange from-2°-8°）.There were significantly differences（P〈0.01）. The VAS of back pain was 7.2±1.3（arrange from1-3） pre-operatively and 2.2±0.3 post- operative 2 weeks, and there were differences（ P〈0. 01）. All of the patiens have no developed severe complications. Conclusion： Anterior screw-rod internal fixation system, as well as decompression and fusion with bone graft is more conducive to nerve decompression and reconstruction of spinal stability,which is an effective and safe procedure to treat thoracolumbar old burst vertebral fracture.