AF复位固定结合椎体成形术治疗胸腰椎爆裂性骨折

目的探讨AF椎弓根固定复位并椎体缺损空洞部位充填骨水泥,即刻获得骨折椎体前、中、后三柱稳定的方法治疗胸腰椎爆裂性骨折的疗效。方法对16例胸腰椎爆裂性骨折,采用短节段椎弓根AF系统复位内固定,根据临床神经症状和影像资料行椎管减压或不减压。复位后经后路向伤椎内骨缺损注射骨水泥充填缺损即刻获得骨折椎体前、中、后三柱稳定。术前及术后随访行X线检查,测量伤椎椎体高度变化和相邻间隙变化等。了解术后骨折复位情况以及随访期间内固定有无失败和复位丢失情况。结果16例均获随访,椎体高度恢复并维持良好,无塌陷、间隙无明显改变,术前神经症状消失。结论AF短节段复位固定、骨水泥充填伤椎骨缺损即刻获得骨折椎体前、中、后三柱稳定治疗胸腰椎爆裂性骨折不仅能有效地填充椎体内骨缺损,而且可早期下床活动,无椎体高度丢情况。

Atlas Fixator Transpediculate Internal Fixation Combined with Vertebroplasty for Treatment of Thoracolummbar Burst Fracture

Objective To evaluate the efficacy of AF(atlas fixator) transpediculte internal fixation combined with vertebral cement filling in the treatment of thoracolummbar burst fractures Methods Sixteen patients with thoracolummbar burst fractures were treated using AF instrumentation short-segment transpedicular reduction and internal fixation.Some of them were decompressed and some of them were not decompressed according to the clinical nervous symptom and radiographs.After reduction,the injured vertebra were filled with cement from posterior.The immediate stability of the anterior,middle and posterior collumns was obtained.Sixteen patients were followed up for 9 months to 30 months.X-ray examination were done preoperatively and postoperatively.The heights of injured vertebra were measured.The reduction of fractures was investigated as well as whether there was failure of fixation and the collapse of vertebral body in the period of folloeup.Results All of the follow-up patients recovered completely without the collapse of vertebral body and nervous symptom.Conclusion After AF short-segment reduction and fixation and cement filling,the 3-column stability of injured vertebra is soon obtained and the patients could move early.