自制L型骨块复位器在治疗胸腰椎爆裂性骨折致骨块椎管内占位的应用

目的探讨自制L型骨块复位器在治疗胸腰椎爆裂性骨折致骨块椎管内占位中的应用方法。方法对24例胸腰椎爆裂性骨折患者,先用AF系统撑开恢复损伤节段的高度,再采用自制L型骨块打入复位器,使突出骨块复位,行AF系统骨折固定。结果24例均获随访,平均14（12-24）月。疗效评价：优20例,良1例,差3例,优良率为87.5%。术后1年Frankel分级：A级3例,为术前A级T12骨折者,余21例均可下地步行,其中1例术前B级的T12骨折患者出现痉挛步态,经锻炼后逐渐缓解。24例均于术后1年取出内固定。结论对胸腰椎爆裂性骨折致骨块椎管内占位患者,应用自制L型骨块复位器复位疗效好,安全可靠,可操作性强,值得推广。

Application of the Self-made L-shape Bone Repositor for Thoracolumbar Bursts Fractures with Bone Fragments in Vertebral Canal

Objective To explore the reduction techniques with self-made L-shape bone repositor in treatment of the bone fragments occuppied in vertebral canal in thoracolumbar bursts fractures. Methods 24 cases of thoracolumbar bursts fractures were underwent the injured vertebral body brace to recover the height by Atlas Fixation （AF） System at first. And then, the bone fragments occuppied in vertebral canal were reposited by beating the L-shape repositor with bone hammer. Finally, the fractures were fixated by AF system. Results All cases were followed up for 12 to 24 months （ mean 14）. The outcomes showed excellence in 20, good in 1 , and poor in 3, and the fineness rate was 87.5%. 3 cases with T12 fracture, grade A classified preoperatively by Frankel standard, were not improved. The other 21 cases were recovered to walking. Among them, one T12 fracture case with Frankel B preoperatively showed spastic gait and relieved gradually by exercise. Conclusion The reduction method is effective, safe and feasible by application of the Lshape bone repositor for resetting the bone fragments occuppied in vertebral canal in thoracolumbar bursts fractures.