后路钉棒系统置入内固定并侧前方减压植骨融合治疗胸腰椎严重爆裂骨折12例

背景：胸腰椎爆裂性骨折侧前方减压植骨融合、钉棒系统内固定术可通过同一切口实现。目的：观察后路钉棒系统置入内固定并侧前方减压植骨融合治疗胸腰椎严重爆裂骨折合并脊髓及神经根损伤的临床疗效。方法：回顾采用后路钉棒系统置入内固定,侧前方减压植骨融合治疗12例胸腰椎爆裂骨折合并神经损伤的病例。结果与结论：12例患者椎管均获得有效减压,均随访9个月以上。影像学显示植骨块融合良好,伤椎高度基本恢复,Cobb’s角由术前平均22°恢复到6°,Frankel分级恢复1级者6例,恢复2级者3例,无变化者3例。结果表明,采用后路钉棒系统内固定加侧前方减压椎体次全切除植骨融合是集减压、复位、内固定、植骨融合、矫正畸形、重建脊柱稳定一次完成的有效方法,但应严格掌握适应证。

Posterior screw-rod system fixation combined with anterolateral decompression and bone graft for severe thoracolumbar burst fracture in 12 cases

BACKGROUND：The procedures of anterolateral decompression,bone graft with mesh and internal fixation with screws and rods can achieve through the same incision in the treatment of thoracolumbar burst fractures.OBJECTIVE：To evaluate the clinical effects of anterolateral decompression,bone graft with mesh and internal fixation with screws and rods in the treatment of thoracolumbar burst fractures.METHODS：Twelve thoracolumbar burst fracture patients with neurologic deficit were treated with anterolateral decompression,bone graft with mesh and internal fixation with screws and rods.RESULTS AND CONCLUSION：The mean follow-up time was 16 months.Sufficient decompression,excellent fusion of bone graft and recovered vertebral body height were achieved in all cases.The Cobb＇s angle was rectified from preoperative 22° to 6° postoperatively.And Frankel grade scores were significantly improved in 9 cases（grade 1 in 6 cases,grade 2 in 3 cases,and no changes in 3 cases）.The procedures of anterolateral decompression,bone graft with mesh and internal fixation with screws and rods are effective,which can achieve anatomical reduction,complete decompression and restabilization through the same incision.But the operation indications should be restrictedly controlled because of the more trauma and blood loss.