二种经椎弓根固定器治疗脊柱骨折的比较

目的 :比较三种椎弓根固定技术在脊柱骨折治疗中的临床效果。方法 :采用多种型号椎弓根固定器Dick、SteffeeRF或AF治疗胸腰椎骨折 2 5 3例。选择其中具有代表性的钉板结合的Steffee与钉杆结合的Dick固定器固定的12 2例 )不含截瘫的病例 )。经 3、6、12个月的随访 ,对术后椎体高度丢失及畸形作比较分析。结果 :Dick固定器结构复杂不易安装 ,术后易发生松动 ,椎体高度丢失及畸形再出现。Steffee固定器结构简单、易安装 ,尤其适用于骨折合并脱位及后突畸形者 ,优于Dick固定器 ,经用STATA软件进行t检验处理P <0 .0 0 1。结论 :作者认为临床上要根据骨折类型及医生的技能合理选用结构简单、操作方便、固定可靠的固定器 ,以提高治疗效果

A Comparative Study on the Technique of Pedicle Screw Fixation in the Treatment of Thoracolumbar Fracture

Objective:The technique of pedicle screw fixation has been widely used in the treatment of spine fracture, and it has achieved good results in clinical applications. Methods:From 1990 to 2000, we adopted various kinds of pedicle screw fixations in the treatment of 253 cases of thoracolumbar fracture, such as Dick, Steffee, RF, AF. We choose the representative two kinds of fixations applied in 122 cases ,the screw-plate Steffee fixation and screw-rod Dick fixation. From the three to twelve months follow-ups, we compared them from the aspects of reducing in operation, height losing of vertebral body after operation and malformation. The result shows that Dick fixation is complexly difficult to install, easy to loosen, the vertebral body height lose and malformation emerge once again after operation. Steffee fixation is simple in construction, easy to install, it is especially suitable for the treatment of fracture complication dislocation and kyphotic deformity. It is better than the Dick fixation(P<0.01). Conclusions:According to the fracture type and the technical ability of the surgeon, we should choose the fixations simple in construction, easy to install and reliable to fix.