胸腰椎骨折后路椎管减压AF内固定

目的:研究AF椎弓根螺钉固定的临床治疗方法和治疗效果。方法:对41例胸腰椎骨折行内固定,有椎体或椎板骨折导致椎管狭窄和脊髓压迫,应进行椎管减压,并常规行小关节及横突间植骨。术后常规引流48 h,植骨者术后卧床4周,佩带支具1年。结果:41例中随访36例,随访时间3~36月,平均17.5月。根据手术前后影像学评价(椎体高度的恢复,椎管侵占率,脊核后凸cobbs'角)和神经功能评价(Francel分级),优良率80.5%,其中2例分别于手术后7个月和9个月出现固定系统的松动,经取出固定系统、卧床佩带支具后病情稳定,骨折愈合。结论:AF椎弓根螺钉固定牢固可靠,能达到精确复位固定及椎管有效减压,疗效确切。

Treatment of Thoracolumbar Fracture with AF Device Fixation and Vertebral Body Graft via Spinal Canal

Objective:To approach the operative method and clinic effect of AF device fixation and vertebral body graft via spinal canal for treatment of thoracolumbar fracture.Methods:Forty-one cases with thoracolumbar fracture were treated with AF device fixation and vertebral body bone graft via spinal canal and posterior bone graft.After operation,the patient should lie on bed for 4 weeks.The back was wrapped with the waist fixation for 1 year.Results:Thirty-six cases were followed up for 3 months to 3 years,which gained excellent and good results,(80.5%)through evaluations of fluoroscopy(recovery of the height of lumbar vertebras,the invasion of the tube and the Cobb angle of the spinal surface) and neuro pathological function(Frankel grade)of inter-operation and post-operation.There were no breaking of nails and shafts,and other complications.Conclusion:AF fixation can restore and fix the thoracolumbar spinal fracture,vertebral body graft via spinal canal and posterior bone graft can increase the stability of the spine.