短节段固定椎间融合治疗胸腰椎陈旧骨折并后凸畸形

目的：探讨经后路短节段固定、椎间固定融合治疗胸腰椎陈旧骨折合并后凸畸形的有效性。方法采用后路短节段固定、椎间固定融合治疗胸腰椎陈旧骨折合并后凸畸形21例，全部患者均有不同程度腰背部疼痛，严重者合并下肢神经损伤症状，术前后凸 cobb 角度为19°～42°，平均28°。其中，共有8例骨块突入椎管内，骨块突入椎管内占矢状径1／3者4例，1／2者2例，大于1／2者2例。术前、术后、随访时测量后凸 cobb 角，并评估神经损伤程度 Frankel 分级。结果本组病例手术均顺利完成，患者神经功能均有不同程度恢复和改善。术后 X 线片检查显示所有的患者均示骨性愈合，内固定物无松动、断裂，椎间融合器无塌陷。术后 cobb 角为0～11°，平均4．8°。结论采用后路短节段固定、椎间固定融合治疗胸腰椎陈旧骨折合并后凸畸形创伤小，出血少，方法简单，矫形效果良好，不失为一种较好的方法。

Short segment fixation and interbody fusion in the treatment of old thoracolumbar fractures and kyphosis

Objective To investigate the effectiveness of posterior short segment fixation ,intervertebral fixation and fusion in treatment of old thoracolumbar fractures with kyphotic deformity .Methods 21 cases of old thoracolumbar fracture with kypho‐sis were treated by posterior short segment fixation ,interbody fusion fixation ,All patients had different degrees of low back pain ,the serious symptoms associated with lower limb nerve injury .Before operation ,kyphotic Cobb angle is 19° ~ 42 ° ,28 °av‐erage .Among them ,there were 8 cases of bone protruding into the spinal canal ,4 cases of bone fragments into the spinal canal sagittal diameter of 1/3 ,2cases of 1/2 ,2 cases of greater than 1/2 .Results This group of patients were successfully completed operation ,patients have different degree of restoration and improvement in neurologic function .X‐ray examination after opera‐tion showed that all patients showed bone union ,internal fixation without loosening ,fracture ,lumbar intervertebral fusion de‐vicewithout collapse .Postoperative Cobb angle was 0 ~ 11 degrees ,the average of 4.8 ° .Conclusion Using posterior short seg‐ment fixation ,intervertebral fixation and fusion is a kind of good method of small trauma ,less bleeding ,simple method ,good correction effect in treatment of old thoracolumbar fractures with kyphotic deformity .