摘要
目的探讨后路经椎弓根钉棒系统内固定治疗多节段胸腰椎骨折的临床效果.方法21例多节段胸腰椎骨折,根据唐三元分类法ⅠA型骨折19例.ⅡA型骨折2例.神经功能按Frankel分级:A级7例,B级4例,C级3例,D级4例,E级3例,均在2周内行后路经椎弓根螺钉内固定治疗,手术前和随访时分别进行Frankel评分和锥体高度及后凸角度的测量,并进行对比分析.结果X线片示后凸角由术前平均24°(15～48°)矫正到术后平均5°(0～10°),椎体前缘高度由术前平均38%(20%～65%)恢复到术后平均95%(85%～100%),随访时间7～48个月,平均25个月,椎体高度无丧失,内固定无松动、断裂,7例Frankel A级的患者,其中2例无变化,5例恢复至B级,3例B级恢复至C级,1例B级恢复至E级,3例C级恢复至E级,4例D级恢复至E级,3例Frankel E级的患者术后无神经功能障碍.结论后路经椎弓根钉棒系统内固定治疗多节段胸腰椎骨折,方法可行,疗效满意。
Objectivo To explore the outcomes of applying pedicle screws to fix multiple - level thoracolumbar fractures. Mothods 21 patients with the multiple - level thoracolumbar fracture were studied, in which 19 cases were type IA and 2 cases were type IIA fracture according to Tang San - yuan multiple - level spine fracture classification. According to Frankel＇ s grade, there were 7 cases of grade A, 4 case of grade B, 3 cases of grade C, 4 cases of grade D and 3 cases of grade E. These cases were carried out posterior surgery with Pedicle screws internal fixation within 2 weeks. The Frankel score, vertebras body high and angle of kyphosis deformity were checked and compared between pre - operation and following up. Results X - ray showed that the kyphosis deformity angle was corrected from pre -operation 24° （ranging from 15 ～ 48°） to post -operation 5° （ranging from 0～ 10° ）. The height of anterior border vertebra was improved from pre - operation 38% （ ranging from 20% ～65% ） to post - operation 95% （ ranging from 85%～ 100% ）. All patients were followed up from 7 ～ 48 months （averaging 25 months）. No vertebral height losing and no loose or breakage of the pedicle screws occurrences. In the 7 cases with pre - operation grade A, 2 cases remained unchanged and 5 recover to grade B. 4 patients with grade D, 3 cases with grade C and 1 case with grade B were recovered to grade E. 3 cases with grade B were recovered to grade C. 3 cases of Frankel grade E were no neurologic deterioration post - operation. Conclusion It is feasible to applying pedicle screws to fix multiple -level thoracolumbar fractures, and the outcomes are satisfying.
出处
《昆明医学院学报》
2007年第5期48-51,59,共5页
Journal of Kunming Medical College
关键词
多节段胸腰椎骨折
椎弓根钉
手术治疗
Multiple -level thoracolumbar fractures
Pedicle screw
Surgical treatment
