胸腰椎Chance骨折经椎弓根外固定器治疗

本文报告9例胸腰椎Chance骨折经椎弓根外固定治疗情况。外固定器螺钉采用经皮经椎弓根进针方法。手术时间约45min。固定后下地活动时间平均7d。所有病例均获随访,平均10月(8～20个月)。本组无严重并发症,X线片随访,本组骨折区均获骨性愈合。作者认为Chance骨折发病机制多种多样,但治疗核心是对病椎后柱加压固定。经椎弓根外固定器可灵活调整器械结构,使病椎后柱加压固定效果更为直接。

The Transpedicular External Fixation for the Treatment of Chance''''s Injuries of the Thoracolumbar Spine

The authors reported 9 cases of Chance' s injuries of the thoracolumbar spine treated by transpedicular external fixation. The pedicular screws were driven into the vertebral body transpedicularly by a closed technique. Time of operation was 45 minutes. Most patients began to walk within 7 days inaverage after surgery. The average time for removal of the fixation device were 17 weeks. All patients had been followed for an average period of 10 months (ranging from 8 months to 20 months). No serious compliciations were seen. All of them were considered to be healed by radiological techniques. The authors considered that there are many injury mechanism in Chance ' s fracture of the thoracolumbar spine, but core of the treatment is compressive fixation in the posterior column of the injured vertebra. With the transpedicular external fixation, it is possible to provide a direct effect in posterior column because external fixation apparatus can be easily performed.