脊柱胸腰段不稳定骨折的手术治疗

目的：探讨脊柱胸腰段不稳定骨折的手术治疗效果,并比较不同种类后路内固定方法的优缺点。方法：临床收治脊柱胸腰椎骨折患者２５６例,均采用后路内固定手术,包括Ｈａｒｒｉｎｇｔｏｎ棒、Ｅｄｗａｒｄｓ装置改良Ｅｄｗａｒｄｓ系统、Ｄｉｃｋ钉和ＲＦ５种内固定装置,比较手术前后骨折复位（包括畸形角、矢状面位移、伤椎高度）以及神经功能恢复情况。结果：后畸形角由术前２６．８°矫正到术后５．２°,矢状面位移由术前的１９

Internal fixation with spinal instrumentation for the management of unstable thoracolumbar fractures

AIM: To eva1uate the efficacy of instrumentationin the management of thoracolumbar fractures- METHODS:Between January 1984 and December 1998, 256 consecutivepatients, who suffered from unstable thoraco1umbar frac-tures, were' treated surgically with spinal instrumentation,including Harrington device, Edwards system, modified Ed-wards system, Dick device and RF system and follow-up was' conducted, averaging 3O months. RESULTS: Kyphotic de-formity was corrected from 26. 8" preoperatively to 5. 2" post-operatively, translation was reduced from 29. 9% to 3. 1 %and the height of compressed vertebral bodies was restoredfrom 53. 2% to 94. 1% of the normal height. Neurologicfunction of 9O- 7% cases improved above Frankel grade one.Of the five devices, RF got the most satisfactory results incorrecting kyphotic deformity and modified Edwards systemin the correction of translation. CONCLUSION: Internal fix-ation with spinal instrumentation is an effective method forthe management of unstable thoracolumbar fractures.