单螺纹Schanz钉内固定治疗胸腰椎爆裂骨折伴不全截瘫

Treatment of thoracolumbar vertebrae burst fracture with Schanz screw internal fixation

目的 :观察后路单螺纹Schanz钉内固定撑开装置间接减压治疗胸腰椎爆裂骨折伴不全截瘫的疗效。方法 :对 13例胸腰椎爆裂骨折伴不全截瘫病人 ,单螺纹Schanz钉内固定撑开 ,恢复椎体正常高度、脊柱正常生理曲度及椎管容积 ,不进入椎管间接减压 ,椎板植骨。结果 :术后CT、X线复查 ,椎体高度恢复 ,椎管容积基本正常 ,脊柱正常生理曲度恢复。平均随访 2 1个月 ,骨愈合时间 3个月 8例 ,4个月 5例 ,无 1例断钉及骨不愈合。 13例按Frankel分级术后均恢复至E级。结论 :后路单螺纹Schanz钉内固定撑开装置间接减压治疗胸腰椎爆裂骨折伴不全截瘫具有手术操作简便 ,扩大了椎管容积 ,解除了脊髓式马尾神经受压 ,且重建了脊柱的稳定性 。

Objective To observe the effect of posterior Schanz screw internal fixation with indirect decompression on the treatment of thoracolumbar vertebrae burst fracture with incomplete paraplegia.Methods Thirteen cases of thoracolumbar vertebrae burst fracture with incomplete paraplegia were surgically treated.Posteriorly,Schanz screws were internally fixed and enlarged,the height of vertebrae was restored and piesces of bone were grafted in patients.Results After operation,X-ray films and CT scan demonstrated that the height of corpus vertebrae,the area of spinal canal and sagittal plane were all restored to normal.The average period of follow-up was 21 months.And there was no case of damaged Schanz instrument or bone nonunion.According to Frankel's grading,nerve functions totally improved to E grade after operation.Conclusion The operation of Schanz screw internal fixation has the advantages of simplicity,speediness,less bleeding,slight disturbance to spinal canal,and effective indirect decompression.In addition,the spinal stability is rebuilt,and the improvement of sagittal plane and nerve function is well obtained.