摘要
目的总结治疗胸腰椎爆裂骨折的临床经验,推广其临床应用。方法 24例单椎体胸腰椎爆裂骨折病例,其中男16例,女8例;年龄20～75岁。损伤节段:T111例,T125例,L18例,L27例,L32例,L41例。伤后至手术时间3～5d,均为爆裂骨折。术前椎管占位率25%～65%。脊柱后凸程度(Cobb角):14～35°,椎体压缩至正常的10%～55%。Frankel分级:A级2例,B级4例,C级6例,D级5例,E级7例。按置钉→减压→复位→植骨步骤进行。结果随访12～18个月,未发现继发性后突畸形,椎体高度恢复至正常的85%～100%,椎管占位率5%～15%。脊柱后凸程度(Cobb角):平均3°,Frankel分级:A级1例,B级2例,C级2例,D级4例,E级15例。结论经伤椎椎弓根植骨联合AF内固定系统治疗胸腰椎爆裂骨折,可在早期稳定的基础上为伤椎椎体的长期稳定提供物质基础,避免因复位后"空壳椎体"的形成,从而减少术后并发症,有临床推广价值。
Objective To summarize the clinical experiences in the treatment of single thoracolumbar burst fracture in order to spread its application in clinic.Methods The 24 patients（age range：20～75yr） with single thoracolumbar burst fracture were enrolled in the study,including 16 males and 8 females.Among them,there was 1 case whose injure segment was located on T11,5 cases on T12,8 cases on L1,7 cases on L2,2 cases on L3,1 cases on L4.The duration from injury to operation was 3～5 days,and all the patients were thoracolumbar burst fracture cases.The percentage of fragment in spinal canal was 25～65% before operation.The Cobb＇s angle varied at 14～35°,and centrum was compressed to 10%～55% of normal one.The Frankel classification was 2 cases at grade A,4 cases at grade B,6 cases at grade C,5 cases at grade D and 7 cases at grade E.The operation was performed in the order of pedicle screw fixation → decompression →reduction→bone grafting.Results All the patients were followed up for 12～18 months,and no secondary kyphosis malformation was found.The vertebral body height was recovered to 85%～100% of normal one,and the percentage of fragment in spinal canal was 5%～15%.The average Cobb＇s angle was 3°.The Frankel classification was 1 cases at grade A,2 cases at grade B,2 cases at grade C,4 cases at grade D and 15 cases at grade E.Conclusion The transpedicular intracorporeal bone grafting combined with AF internal fixation in the treatment of thoracolumbar burst fracture can provide material basis for the long-term stabilization of the thoracolumbar body of spine on the basis of early stabilization,and can avoid the formation of ＂empty shell centrum＂ because of reduction,as a result,which can reduce the incidence of complications after operation,so,which deserves more application in clinic.
出处
《河北医药》
CAS
2012年第17期2568-2569,共2页
Hebei Medical Journal
关键词
经椎弓根植骨
胸腰椎爆裂骨折
高度丢失
transpedicular intracorporeal bone grafting
thoracolumbar burst fracture
height loss
