前路Z-plate钛板治疗胸腰椎陈旧性骨折

目的探讨前路减压、支撑植骨重建脊柱前中柱结构及Z-plate钛板内固定治疗胸腰椎陈旧性骨折的临床疗效。方法自2005年10月～2009年3月对17例胸腰椎陈旧性骨折的患者行前路减压、大块髂骨椎间支撑植骨融合及Z-plate钛板内固定治疗,影像学评价脊柱后凸畸形（cobb角）纠正、内固定稳定性及植骨愈合情况。结果随访3～26月,平均13.2月,后凸cobb角术前平均32.2°,术后平均12.8°。椎管减压彻底,内固定钛板无松动、移位及断裂,所有病例植骨均获骨性融合,脊柱后凸畸形获得良好矫正,无畸形矫正的丢失。结论前路减压支撑植骨融合钛板内固定,有利于畸形矫正和神经功能恢复,重建脊柱稳定性好,是治疗陈旧性胸腰椎骨折的有效方法 。

Treatment of thoracolumbar old fracture by anterior Z-plate titanium plate

Objective to discuss the clinical effect of thoracolumbar old fracture by anterior decompression, supporting graft to reconstruct anterior and middle spinal column structure and Z-plate fixation with titanium plate. Methods since October 2005 to March 2009, 17 cases of thoracolumbar old fracture patients were treated by anterior decompression, large iliac intervertebral supporting fusion and Z-plate fixation with titanium plate. Imaging evaluate kyphosis（cobb angle） was corrected, fixation was stable and graft was healing. Results follow-up 3 ～ 26 months, average 13.2 months, preoperative kyphosis cobb angle was average 32.2 °, Postoperative was average 12.8 °.Spinal depressurize completely, titanium plate fixation without loosening, deformity correction without losing. Conclusion anterior decompression, supporting fusion and Z-plate fixation were useful to recover deformities and neurological function, reconstruct spinal stability,they were effective way to treatment of thoracolumbar old fractures.