新型C形椎管内骨折块复位器治疗胸腰椎骨折的临床研究

目的:评估自制C型椎管内骨折块复位器在胸腰椎骨折后路手术中的疗效及应用价值。方法:36例病人手术前CT及MRI提示胸腰椎骨折并伴有椎体后缘骨折块突入椎管压迫脊髓,行后路切开复位椎弓根钉棒系统内固定+全椎板减压,用自制C型椎管内骨折块复位器在后侧方推挤使椎体后缘骨折块复位,达到恢复椎管容积的目的,并自体骨横突间植骨,术后随访以评价脊柱矫形、椎管占位、复位及神经功能恢复情况(Frankel分级法)。结果:术后X光平片、CT检查36例椎管容积均恢复至正常80%以上,。术后随访6~72月(平均24月),未发生椎体后突畸形,Frankel分级平均进步1~2级。结论:自制C形椎管内骨折块复位器扩大了胸腰椎骨折后路手术治疗适应证范围,复位效果确切,操作简便安全,值得推广。

A Clinical Study of Thoracic and Lumbar Fractures treated by a New Home-made Replacement Apparatus-C within Vertebral Canal

Objective：To evaluate the clinical effects of a new home-made replacement apparatus-C within vertebral canal on posterior-approach operation in treating thoracic and lumbar fractures.Methods：Thirty-six cases who suffered from thoracic and lumbar fractures were treated with posterior-approach operation by home-made replacement apparatus-C in vertebral canal,full-laminectomy,and fixed with pedicle screw and self-bone transplant between transverse process.The reshaping of vertebral collumn,volume of vertebral canal,and Frankel grading were evaluated.Results：A follow-up of 6 to 72 months（24 months on average） was conducted,indicating that there was no kyphosis deformity,and Frankel grading also improved by one or two grades after the operation.Conclusion：The home-made replacement apparatus-C can broaden the adaptation of posterior approach operation on thoracic and lumbar fractures,which was simple and effective,deserving more widely cinical application.