老年性骨质疏松合并腰椎骨折的手术治疗

The Operative Treatment for Fractures of Lumbar Vertebra Associated with Osteop orosis using Atlas Fixation System

目的 :总结AF钉治疗老年性骨质疏松合并腰椎骨折的经验。方法 :回顾性分析 13 7例老年性骨质疏松合并腰椎骨折患者采用AF钉内固定治疗 ,临床评价手术前后椎体的复位固定情况和神经功能。结果 :随访 6个月～ 2年 ,全部骨折 10～ 18周愈合 ,平均愈合时间 12周 ,AF内固定无断裂、松动、无椎体再压缩等并发症。椎体高度恢复 ,Cobb角由术前平均 2 0 6°恢复到 3 2° ,远期椎体高度无丢失 ,无严重腰痛和下肢痛。 2 5例伴有脊髓神经损伤的患者ASIA评级平均提高 1～ 2级。结论 :采用AF钉治疗老年性骨质疏松合并腰椎骨折 ,能有效缓解疼痛 ,具有良好的复位和固定作用 ,术后椎体高度维持好 ,可减少腰椎骨折并发症。

Objective:To sum up the clinical experience on treatment of fractures of lumbar vertebra associated with osteoporosis using atlas fixation system.Me thods:137 cases of fractures of lumbar vertebra associated with osteopo rosis u sing atlas fixation system The neurological function and the reduction were co m pared between preoperation and postoperation Results:137 cases we re followed up from 6 months to 2 years, all cases were healed after 10～18 weeks,fracture healing average time was 12 weeks.AF internal fixation without breaking of nails and shafts,loosing and other complications.The height of lumbar vertebrae were recovered No apparent deformation of the spine or the pain in the waist and leg There was a restoration of Cobb angle from mean preoperative 20 6°to post op erative 3 2°.25 cases of nerve injury had raised their ASIA grade by 1～2 Con clusion:AF internal fixation is effective in reduction and fixation of fra ctur es of lumbar vertebra associated with osteoporosis with a satisfactory postoper ative maintenance of induction.It can reduce the complication of fractures We c o nsider that it is an ideal internal fixation inducement for the treatment of fra ctures of lumbar vertebral associated with osteoporosis.