后路经伤椎置钉短节段固定治疗胸腰椎爆裂性骨折

目的探讨后路经伤椎置钉连续短节段固定治疗胸腰椎爆裂性骨折的临床疗效。方法分析自2004年8月～2010年12月手术治疗的177例单节段胸腰椎爆裂性骨折的临床资料,均采用后路切开复位经伤椎置钉连续短节段固定手术,术后及随访均行X线检查,测定并比较两组伤椎前缘压缩比和Cobb角大小,同时观察神经功能恢复情况。结果 152例得到随访1～7年,平均3.8年。患者术后伤椎椎体高度得到恢复,Cobb角得到矫正;伤椎前缘压缩比和Cobb角术后1周较术前均有明显改善(P<0.05),末次随访时与术后1周对比差异无统计学意义(P>0.05)。结论经伤椎连续固定后能有效的阻止术后椎体高度的丢失和防止后凸畸形的发生,明显降低了远期并发症,是治疗胸腰爆裂骨折的有效手段。

Treatment of thoracolumbar burst fracture with short-segment pedicular screw fixation through fractured vertebra by posterior approach

Objective To investigate the therapeutic effect of continuous short-segment pedicular screw fixation through the fractured vertebra on thoracolumbar burst fractures.Methods From August 2004 to December 2010,177 cases of single segment thoracolumbar burst fractures underwent operation in our hospital and the clinical data were analyzed retrospectively.All patients had operation of continuous short-segment pedicular screw fixation through the fractured vertebra by posterior surgical approach.X-rays were reviewed postoperatively and at follow-up time.The front compression ratio of injured vertebra and the Cobb angle were measured and compared between the preoperative and postoperative index.The neurological function recovery was observed simultaneously.Results All of 152 cases achieved follow-up and the follow-up time was 1～7 years,with an average of 3.8 years.Compared with the preoperative condition,the height of fractured vertebra was restored and the Cobb angle was corrected.The front compression ratio of fractured vertebra and the Cobb angle were significantly improved after surgery,with significant differences(P <0.05).No significant difference showed at the last follow-up,compared with postoperative condition(P >0.05).Conclusion The method of continuous fixation through fractured vertebra can effectively prevent postoperative loss of vertebral height and kyphosis,also reduce the occurrence of long-term complications significantly.Thus it is an effective means to treat thoracolumbar burst fractures.