伤椎过渡钉辅助复位技术在重度胸腰椎骨折脱位手术中的应用

目的探讨伤椎过渡钉辅助复位技术在重度胸腰椎骨折脱位手术中的临床应用价值。方法自2010—01—2012—01应用伤椎过渡钉复位技术治疗重度胸腰椎骨折脱位13例。术前影像学证实伤椎椎弓根均破坏，无法置钉，常规行后路手术．伤椎过渡钉辅助复位后采用椎弓根钉棒系统复位固定。结果13例获得随访10个月～2．5年，平均1．5年，骨折脱位复位满意，术后伤椎高度和Cobb角均有明显改善，差异有统计学意义（P〈0．05），内固定无破坏。结论对于复位困难的重度胸腰椎骨折脱位，当伤椎椎弓根破裂无法置钉时采用伤椎过渡钉辅助复位技术联合后路钉棒系统可以获得满意的复位效果，手术创伤小，操作简单，临床效果满意。

Assistant reduction with transition screw of injured vertebrae in treatment of severe fracture-dislocation of thoracic and lumbar spine

objective To investigate the value of clinical application of assistant reduction with transition screw of injured vertebrae in the treatment of severe fracture-dislocation of the thoracic and lumbar spine. Methods From Jan. 2010 to Jan. 2012, 13 patients with severe fracture-dislocation of the thoracic and lumbar spine were treated with technique of assistant reduction with transition screw. According to preoperative imaging data, all the pedicles of injured vertebrae were broken and unable to be placed regular pedicle screws. All the patients underwent posterior operation with assistant reduction with transition screw of injured vertebrae, followed by pedicle screw fixation. Results The patients were followed up for 10 months to 2.5 years, 1.5 years on average. X-rays showed satisfactory reduction. Height loss of injured vertebrae and Cobb＇s angle were significantly improved after operation （P 〈0.05）. Loosening of internal fixation was not found during the follow-up. Conclusion Technique of assistant reduction with transition screw combined with pediele screw fixation might get satisfactory reduction in the treatment of irreducible severe fracture-dislocation of the thoracic and lumbar spine while the broken pediele is unable to be placed regular pedicle screws. This simple technique might cause less surgical trauma, which might get satisfactory clinical results.