前路减压植骨钛钢板固定治疗胸腰椎爆裂型骨折

目的 探讨前路减压、植骨融合及钛钢板内固定治疗胸腰椎爆裂型骨折的临床效果。方法 采用前路减压、植骨及钛钢板固定术治疗胸腰椎爆裂型骨折38例，并截瘫28例，椎管骨性占位、硬膜受压、但无神经症状10例。结果 随防8-46个月，平均19个月。伤椎高度恢复90％26例。恢复80％12例。无钢板螺钉断裂和松动现象。截瘫者术后脊髓神经功能按Flankel分级。除A级3例未能恢复外。其余恢复1～2级。结论 胸腰椎前路减压植骨钛钢板固定具有减压彻底、固定牢靠、并发症少、力学性能好等优点．是治疗胸腰椎爆裂型骨折较理想的方法。

Treatment of thoracolumbar fracture by anterior route decompression, bone graft and plate internal fixation

Objective To study the clinical outcome of thoracolumbar fractures treated by anterior route decompression, bone graft and plate internal fixation. Methods From January 1998 to July 2005, thirty-eight cases of thoracolumbar fracture were treated in our hospital and the outcomes were analysed. Twenty-eight of them suffered from spinal cord injuries. All Cases were operated upon by anterior decompression, reduction, autogenous iliac grafting and plate fixation. Results All patients were followed up for 8 to 46 months with an average of 19 months. No plate breakage or screws loose occurred. Among the 38 cases, the height of fractured vertebra was recovered to 90% in 26 cases, 80% in 12 cases. According to Frankel scale, 3 patients recovered as grade A, 3 grade C,8 grade D, and 14 grade E. Conclusion Anterior route decompression, bone graft and plate internal fixation has the advantages of simple manipulation, firm fixation, less complications and good biocompatibility, and thereupon is advocated to use in the treatment of thoracolumbar fractures.