经椎弓根螺钉内固定治疗胸腰椎骨折64例分析

目的探讨和分析经椎弓根螺钉内固定治疗胸腰椎骨折的疗效。方法2001年1月至2008年6月，对64例胸腰椎骨折患者行后路减压、植骨、经椎弓根螺钉内固定治疗。术前神经功能损伤按Frankel分级：A级8例，B级7例，C级15例，D级12例，E级22例。结果64例均获随访，时间为4～36个月，平均14个月，随访结果显示所有病例减压均较彻底，有脱位者均复位，后凸畸形纠正，内固定牢固，术后神经功能恢复情况按Frankel分级：A级5例，B级4例，C级10例，D级14例，E级31例。结论在严格掌握手术适应证的情况下，椎弓根螺钉内固定可提供短节段脊柱内固定，且固定牢固，临床疗效满意，脊柱融合率高。

Treatment of thoracolumbar factures with pedicle screw fixation

Objective To explore the effects of the treatment by means of internal fixation operation through pedicle of vertebral arch for thoracolumbar vertebral fracture cases. Methods 64 cases suffering from thoracic or lumbar vertebral fractures were treated with posterior decompression, pedicle screw fixation and bone graft from January 2001 to June 2008. The Frankel scale was used for the injury of nerve function. 8 cases were rated as Grade A, 7 as Grade B,15 as Grade C,12 as Grade D and 22 as Grade E retrospectively before surgical operation. Results The 64 cases were followed up for 4--36 months with an average of 14 months. The results show that the pressure was reduced sufficiently, and dislocation and kyphosis were corrected and fixation was strong. Neurological status has been improved satisfactorily after operation. 5 cases were rated as Grade A,4 as Grade B, 10 as Grade C, 14 as Grade D and 31 as Grade E in line with Frenkel scale. Conclusion Pedicle screw fixation system can provide solid short-segment internal fixation, satisfied clinic outcomes and high rates of spinal fusion. However, the surgical indications must be selected strictly.