摘要
目的观察椎弓根螺钉在胸腰椎爆裂性骨折治疗中的疗效。方法回顾性分析用椎弓根螺钉治疗的35例胸腰椎骨折患者的临床资料,全部采用后路椎管减压、椎板及横突间植骨加椎弓根螺钉内固定治疗。结果全部病例得到随访,平均17个月(6～72个月)。其中23例脊髓不全损伤患者Frankel分级提高1～3级(平均2级);A级6例有1例恢复到B级,其余患者部分术后感觉平面下降或下肢感觉部分恢复,运动功能无明显改善。术后遗留轻度腰背痛3例,1例螺钉断裂,1年后取出。无一例发生感染。随访病例均行X线片检查,后凸角由术前平均27°(13°～32°)矫正到术后11°(0°～17°),椎体前缘高度矢状径指数术前28°(13°～49°),恢复到术后83°(70°～100°)。结论后路椎管减压、椎板及横突间植骨加椎弓根螺钉内固定治疗胸腰椎爆裂性骨折具有操作相对简单、创伤小、复位效果好和固定可靠等特点,是治疗胸腰椎不稳定骨折的较好方法。
Objective To investigate the pedicle screws in the treatment of thoracolumbar burst fractures in patients.Methods A retrospective analysis applications since 1998,35 cases of pedicle screws in the treatment of patients with thoracolumbar fractures information.All were treated with posterior lumbar decompression lamina and transverse process between the graft and pedicle screw fixation.Results All patients were followed up an average of 17 months（6 to 72 months）,of which 23 patients with incomplete spinal cord injury patients with Frankel grade increased by 1～3（average 2）.grade A in 6 cases,1 case back to the B-class,some of the remaining patients after lower extremity sensory feeling down or partial recovery of motor function was not improved.After remaining 3 patients with mild low back pain,1 cases of screw breakage,one year out,no case of infection.follow-up patients underwent X-ray examination,preoperative kyphosis angle decreased from an average of 27°（13°～32°） after correction to 11°（0°～17°）,sagittal diameter index of anterior vertebral height before surgery 28°（13°～49°）,back to the postoperative 83 °（70°～100°）.Conclusion Posterior lumbar decompression,laminectomy,and intertransverse graft and pedicle screw fixation of thoracolumbar burst fracture is a relatively simple operation,trauma,reduction effect,fixed and reliable,the treatment of unstable thoracolumbar fractures of a better way.
出处
《西部医学》
2011年第8期1476-1477,共2页
Medical Journal of West China
关键词
脊柱骨折
胸腰椎
椎弓根螺钉
Spinal fractures
Thoracic and lumbar
Pedicle screw
