摘要
目的探讨胸腰段椎体爆裂骨折前路减压与脊柱重建的临床效果。方法对2005-01/2008-12收治的29例胸腰段椎体爆裂骨折采用前路减压及髂骨或肋骨植骨加Z-plate内固定系统重建脊柱稳定的临床资料进行总结,通过比较术前、术后和随访时X线片和CT片上Cobb角和骨块椎管占位比例来评价后凸畸形矫正、椎管减压程度及植骨融合情况。结果29例患者术后脊柱序列及生理曲度恢复正常,伤椎椎管内骨折块已完全去除。经平均10个月随访,脊柱序列及生理曲度正常,椎管无占位,植骨融合良好,无继发性后凸畸形发生,无钢板、螺丝钉断裂及松动移位等并发症。结论该手术可一期实现椎管前方直接减压,使神经获得最大限度的功能恢复,Z-plate内固定直接作用于骨折部位可以对椎体间支撑和对植骨加压,促进植骨融合,适合于胸腰段椎体爆裂骨折的脊柱稳定性重建和早期功能恢复。
Objective To investigate the clinical effects of anterior decompression and spinal reconstruction in the thoraeolumbar burst fracture. Methods From January 2005 to December 2008, clinical data of 29 cases with thoracolumbar burst fracture treated by anterior decompression, intervertebral bone grafting with ilium costa titanium mesh, and fixation with Z-plate system were analysed. The sfficacy of treatment was assessed by evaluation of the Cobb angle restoration and reduction of canal compromise. Results After average follow up for 10 months, the spinal sequence and the thoracolumbar spinal curvature was restored to normal. There was no occupation in the vertebral canal. The grafted bone has good fusion. There was no complieatiaon in all the cases, such as secondary posterior process abnormality, break or mobilization of plate screw,ie. Conclusion Not only anterior route operation could decompress the vertebral canal directly and thoroughly, but also make the nerves to obtain maximal functional recovery. Z-plate fixed directly on the fracture bone compress the grafted bone, support the intervertebral bone, and facilitate the bone fusion. It is adapted to rebuild the stability and restore the function of the reconstructed thoracolumbar burst fracture during early period.
出处
《职业卫生与病伤》
2009年第3期151-153,共3页
Occupational Health and Damage
关键词
胸腰椎
爆裂骨折
减压
重建
Thoracolumbar vertebrae
Burst fracture
Decompression
Reconstruction
