前路单节段固定治疗Denis B型胸腰椎爆裂性骨折

Anterior single segmental decompression and fusion to treat thoracolumbar burst fracture of the Denis type B

目的：探讨前路单节段固定治疗Denis B型胸腰椎爆裂性骨折的疗效。方法对18例Denis B型胸腰椎爆裂性骨折患者采用前路单节段固定手术治疗。结果患者均获随访，时间24~36（27．7±5．9）个月。神经损伤ASIA评分：术前25~44（34．6±7．2）分，末次随访时35~50（47．7±9．5）分，较术前平均提高13．1分±3．1分（P 〈0．05）。椎体后凸 Cobb 角：术前15．0°~29．5°（22．89°±6．63°），术后2°~5°（3．13°±0．67°），较术前平均改善19．8°±3．1°（P〈0．05），末次随访时椎体后凸Cobb角：3°~7°（4．06°±0．89°），丢失0．9°±0．2°（P〉0．05）。术后随访患者恢复良好，内固定位置良好，未发现内固定物松动移位及相邻节段明显退变的表现。结论采用前路单节段固定治疗Denis B型胸腰椎爆裂性骨折效果显著，是一种可推荐的治疗方法。

Objective To explore the treatment efficacy of anterior single segmental decompression and fusion for tho-racolumbar burst fracture of the Denis type B. Methods 18 cases of thoracolumbar burst fractures of the Denis type B were treated through anterior single segmental decompression and fusion. Results All the patients were followed up for 24~36 （27. 7 ± 5. 9） months. ASIA motor scores：the preoperative were 25~44（34. 6 ± 7. 2）,final follow-up were 35~50（47. 7 ± 9. 5）,improved 13. 1 ± 3. 1 scores （P 〈0. 05）. The preoperative kyphotic Cobb angle was 15. 0°~29. 5°（22. 89° ± 6. 63°）,the postoperative with 2° ~5°（3. 13° ± 0. 67°）,and the kyphotic Cobb angle of correction was 19. 8° ± 3. 1°（P〈0. 05）, the Cobb angle was 3°~7°（4. 06° ± 0. 89°） at final follow-up, there was only 0. 9° ± 0. 2° of Cobb angle lost （P〉0. 05）. Complications were not found including fixation loosening and adja-cent segment degeneration significantly. Conclusions The treatment of anterior single segmental decompression and fusion is significant for thoracolumbar burst fractures of the Denis type B. The technique is a recommended treatment for thoracolumbar burst fractures of the Denis type B.