椎弓根钉棒系统固定治疗胸腰椎骨折的临床观察

目的观察经后路椎弓根钉棒系统内固定治疗胸腰椎骨折的临床疗效。方法应用椎弓根钉棒系统内固定治疗胸腰椎骨折68例,采用Frankel分级结合X线片、CT影像表现判断疗效。结果随访6-54个月,随访期间有2例椎弓根螺钉松动,1例后期出现断裂并完整取出。椎体前、后缘高度分别从术前平均51.4%和75.8%恢复到93.6%和96.5%,Cobb′s角由术前25.8°降低复到末次随访的6.4°。CT示椎管截面积术前为42.6%,末次随访为92.9%。各项指标与术前比较差异有显著性意义（P〈0.05）,患者术后神经功能按Frankel分级大多数都有1-3级提高,腰背部疼痛也获得不同程度改善。结论后路椎弓根钉棒系统内固定是治疗胸腰椎骨折的一种有效方法 ,其具有创伤小、易控制和固定稳定等优点。

Clinical observation of posterior internal fixation with vertebral pedicle screw and rod system to thoracolumbar spine fractures

Objective To observe the clinical efficacy of posterior internal fixation of vertebral pedicle screw and rod system for thoracolumbar spine fractures.Methods 68 patients with thoracic or lumbar vertebral fractures were treated with posterior internal fixation of vertebral pedicle screw and rod system.The Frankel scale combined with X ray and CT images was used for the judgment of efficacy.Results All the 68 cases were followed up 6-54 months with an average of 19 months.2 cases′ fixations were relaxed during follow up.1 cases′ fixations were fractured and been fully taken out.The average height of anterior and posterior edges of injured spine vertebral were from 51.4% and 75.8% increased to 93.6% and 96.5% before and after operation,respectively.Cobb′s angle was from 25.8° recovered to 6.4° at the last follow up.CT images indicated that vertebral section surface was from 42.6% improved to 92.9%.There were significant difference in each observing indicator compared with those before surgery（P〈0.05）.The Frankel degree of 38 cases with nerve injury symptoms was improved 1-3 degrees after surgery,and the back pains of patients were also relived in different extent.Conclusion Posterior internal fixation of vertebral pedicle screw and rod system is efficient for thoracolumbar spine fractures.