非透视下AF系统固定治疗无或轻微症状胸腰椎爆裂性骨折

Treatment of asymptomatic and mild symptomatic thoracolumbar burst fracture by AF system without image intensifier

目的 探讨在非透视下使用AF系统固定的方法与操作技术 ,使AF等经椎弓根内固定在无术中透视条件的医院能广泛应用。方法 对 14例无或仅有轻微症状的不稳定胸腰椎爆裂骨折患者在非透视下行AF系统复位固定 ,其中行椎管减压 8例。结果 所有病例的定位与进钉均一次完成 ,无一例出现早期并发症。椎体高度和椎管容积的恢复及骨碎片复位满意。所有螺钉基本与终板平行 ,有 4钉出现水平偏差 ,但角度 <5°。结论 严格掌握胸腰椎爆裂骨折的手术适应证和熟练操作程序 。

Objective To investigate the AF system instrumentation without image intensifier so as to extent the application of AF system in grass root hospitals. Methods 14 cases of asymptomatic or mild symtomatic thoracolumbar burst fracture were performed with AF system fixation without image intensifier, of which 8 cases were performed spinal canal decompression simultaneously. Results The localization and screwing were completed in one move in all cases. No early complication was found. The vertebral high and spinal canal capacity recovered satisfactorily. The fragments were reduced. All the screws were parallel with the terminal laminae, except for 4 cases with less than 5° deviation. Conclusion With strict selection of indications and skilled manipulation, AF system fixation can also be performed safely without image intensifier.