前路减压、植骨加内固定术治疗胸腰段严重爆裂性骨折

Treatment of Severe Thoracolumbar Spinal Burst Fracture by Anterior Janompression With Graft and Internal Fixation

目的 探讨前路减压、植骨加内固定术治疗胸腰段严重爆裂性骨折的应用价值 ,以及Z -plate钢板系统在前路手术中的应用效果。方法 回顾分析 1 3例经前路减压、植骨加Z -plate钢板固定术治疗的胸腰段严重爆裂性骨折患者的资料。结果 前路减压、植骨加内固定术疗效满意 ,术中及术后无严重并发症发生。 1 3例患者 1 2例获 3～ 1 5个月随访 (平均随访 4.8个月 ) ,平均融合时间 3.5个月。随访时矫正度无明显丢失。神经功能恢复良好。结论 脊柱胸腰段严重爆裂性骨折采用前路减压、植骨加内固定术具有切实可行的减压效果及良好的固定作用。Z -plate钢板内固定系统手术操作简单 ,植入方便 ,固定可靠 ,可明显减少手术时间及出血量。

Objective To investigate the applied value of anterior decompression with graft and internal fixation in the treatment of severe thoracolumbar spinal burst fracture, and to evaluate the clinical effect of Z-plate implant in the anterior approach. Methods To retrospectively analyze 13 patients with severe thoracolumbar spinal burst fracture,all cases were performed surgical procedure by anterior decompression, autograft and internal fixation with Z-plate implant. Results anterior decompression plus antograft and internal fixation has a satisfied clinical effect without severe complications .12 patients of all cases were followed up 3～15months (average of 4.8 months ).The average time of fusion is 3.5months.The loss of kyphosis was not apparent, and the recover of neural function was very well. Conclusion Anterior decompression with graft and internal fixation has a feasible effective decompression in procedure and shows solid fixation in the treatment of severe thoracolumbar spinal burst fracture. The Z-plate implant has many advantages, such as simple manipulation, less amount of bleeding , and shorten operative time.