椎弓根钉棒系统内固定治疗胸腰椎爆裂性骨折临床观察36例

目的探讨椎弓根钉棒系统内固定治疗胸腰椎爆破型骨折的临床疗效。方法采用后路减压椎弓根钉棒系统内固定治疗胸腰椎爆裂性骨折患者36例。手术前后测量骨折椎体前、后缘高度百分比、Cobbs'角,定期随访并评定神经功能恢复情况。结果术后伤椎椎体前缘高度及Cobbs'角明显恢复(P<0.01),伤椎后缘高度较术前无明显变化(P>0.05)。随访8～26个月,患者均能下地行走,术后6个月复查腰椎正、侧位X线摄片显示36例均骨性融合。3例完全神经损伤患者功能恢复不明显,19例不完全损伤者17例功能恢复到1级以上。结论后路减压、椎弓根钉棒系统内固定治疗胸腰椎爆裂性骨折,能有效恢复椎体高度、生理弯曲及神经功能。

Analysis of the Clinical Effect of Internal Fixation with Pedicle of Vertebral Arch Screw System on 36 Cases with Burst Thoracolumbar Fracture

Objective To explore the clinical effect of posterior decompression and internal fixation with pedicle of vertebral arch screw system on burst thoracolumbar fracture. Method 36 patients with burst thoracolumbar fracture were treated with posterio decompression and internal fixation with pedicle of vertebral arch screw system.The heights of anterior and posterior border and Cobbs＇ angle of compressed vertebral bodies were measured before and after surgery. All patients were followed up regularly and the neurofunctional recovery was evaluatd. Results The heights ofanterior border and kyphosis Cobbs＇ angle of compressed vertebral bodies restored obviously after surgery（P〈0.01） and the heights of posterior border presented no obvious change after surgery （P〉0.05）. The average follow-up periodwas 8～26 months, All patients can walk. The 36 cases show of bone fusion by lumbar and lateral X-ray after 6 months. The neurofunction of 3 patients（Frankel A grade） didn ＇t recover, while improvement of neurofunction at least1 Frankel grade was found in 17 patients（Frankel A～D grade）.Conclusion The method of posterio decompression and internal fixation with pedicle of vertebral arch screw system is effective for burst thoracolumbar fracture. It provides satisfactory restoration of height of vertebral bodies and physiologic postural contour and it facilitates recovery of neurofunction.