AF内固定加椎板关闭术治疗胸腰椎爆裂骨折

目的 比较和评价后路椎板切开骨折复位椎板关闭术和结合AF系统两种不同手术方法在治疗胸腰椎爆裂骨折中的疗效。方法 回顾性分析29例胸腰椎爆裂骨折患者,其中早期8例单纯采用后路椎板切开、骨折复位、关闭椎板的手术;后期用此法并结合AF系统治疗21例。比较术后症状的改善和X线变化。结果 全部病例获得3个月～6年随访,脊髓神经功能及椎体高度均有不同程度恢复。AF内固定组无局部症状,后凸畸形角由术前平均28.4°减少到术后3.1°;单纯组存在腰部症状,后凸畸形角由术前平均26.2°减少到6.9°。结论 AF内固定结合骨折复位椎板关闭术,骨折复位及减压彻底,脊柱稳定性好,术后硬膜外瘢痕粘连少,是治疗胸腰椎爆裂骨折的一种理想方法。

Treatment of thoracolumbar burst fracture by AF internal fixation and vertebral lamina closure

Objective To compare and evaluate the results of different operative methods in thoracolum-bar burst fracture Methods Twenty-nine patients of the thoracolumbar burst fracture were reviewed retrospectively, 8 cases were treated early by simple laminotomy fracture diaplasis and vertebral lamina reduction,another 21 cases by same method later and combining AF internal fixation system. To compare the recovery of local symptoms and X rays. Results Follow-up for 3 months to 6 years all the vertebral fractures were cured, the recoveries of neurological function and the heights of compressed vertebral bodies mostly recovered. The group with internal fixation was no local symptom, kyphosises were corrected from 28.4 degree preoperatively to 3.1 degree postoperatively. The simple group had local pain and lumbar ankylosis, kyphosises were corrected from 26.2 degree to 6.9 degree. Conclusion The method of laminotomy to reposit the fracture and vertebral lamina reduction with combining AF internal fixation system is easy to operate and supply intrinsic stability, decompress thoroughly and minimize the postoperative adhesion. It is an ideal and adjuvant restorable method for thoracolumbar burst fracture.