摘要
目的探讨在下腰椎爆裂性骨折中应用单一后路经椎间孔椎体间植骨融合术重建椎体前中柱的有效性。方法 2009年1月～2011年6月,采用单一后路切开复位椎弓根内固定经椎间孔椎体间植骨融合术治疗下腰椎爆裂性骨折19例。分别评价术前、术后、末次随访时的影像学指标变化,及术前与术后末次随访时神经功能变化。结果 19例患者平均随访15.6个月。所有患者术后未发生切口感染、神经功能损伤及内固定器松动断裂等并发症。末次随访时18例患者证实椎间融合,19例患者术前平均伤椎高度为正常椎体高度的(40.62±12.32)%,术后恢复至(96.52±10.62)%,末次随访时为(95.43%9.54)%。腰椎前凸角术前32.2°±5.1°,术后38.4°±5.2°,末次随访时为38.4°±7.2°。末次随访时伴有神经功能障碍的患者均有1级以上的恢复。结论下腰椎爆裂性骨折行后路椎弓根螺钉内固定经椎间孔椎体间植骨融合术,能完成短节段三柱固定,同时修复了前柱及矫正脊柱后凸,取得满意的骨性融合率。
Objective To evaluate the effect of transforaminal lumbar interbody fusion （TLIF） to suprt the anterior and mid die column for the lower lumbar burst fractures using. Methods From January 2009 to Jun 2011, a total of 19 patients with lower lumbar burst fractures was treated with TLIF. After posterior reduction and shortsegmental fixation, through a TLIF approach sup port the anterior column by using a single dorsal approach. The radiologlcal and clinical outcome was assessed before, ＇after opera tion and at final followup. Results The mean followup was 15.6 months. In this series no deep wound infections, aggravation of neurological function impairment and complication of internal fixation instrument loosening and breaking happened. Postoperative 12 months, 18 cases demonstrated anterior interbedy fusion. The intervertebral height of fractured vertebral body increased from （40. 62 ± 12.32） % preoperative to （96.52 ± 10. 62） % postoperative, and（95.43%9. 54） % at final tollowup. Meanwhile, the lum bar lordosis angel was 32.2°＋5.1°, 38.4° ＋5.2° and 38.4° ＋7.2° preoperative, postoperative, ant at final fellowup respectively. Cases with neurological deficit （ 5 in 19 cases） had obtained improvement of neurological function by 1 grade at final followup. Conclusion From a single posterior approach using transforaminal lumbar interly fusion and pedicle screw were able to achieve shortsegmented 3 columns fixation and restored the weightbearing capability of the anterior column with satisfactory fusion.
出处
《脊柱外科杂志》
2013年第5期261-263,共3页
Journal of Spinal Surgery
关键词
腰椎
脊柱骨折
骨移植
脊柱融合术
Lumbar vertebrae
Spinal fractures
Bone transplantation
Spinal fusion
