胸腰椎爆裂性骨折经伤椎椎弓根螺钉内固定治疗52例疗效分析

目的]探讨胸腰椎爆裂性骨折经伤椎椎弓根螺钉内固定（pecticle screw fixation，PSF）90疗的疗效。方法]选取住院手术治疗的胸腰椎爆裂性骨折52例，均采用经伤椎PSF治疗。比较患者治疗前后疼痛视觉模拟评分（visual analog scale，VAS）、伤椎椎体前、后缘高度压缩率、椎体后凸畸形矫正度、伤椎骨性椎管占位率变换情况及采用美国脊髓损伤学会（american spinal injury association，ASIA）分级标准评定脊髓神经恢复情况。结果]52例患者均顺利完成手术，均采用经伤椎PSF治疗。所有病例均获12个月至24个月以上时间随访。患者腰背痛症状于术后得到缓解，伤椎椎体前、后缘高度和局部后凸畸形、伤椎骨性椎管占住率均得到明显改善，脊髓神经功能术后恢复良好，均有1-2级恢复。所有患者未发生内固定松动、折断等现象，伤椎椎体高度无明显丢失，后凸畸形无复发加重。结论】经伤椎椎弓根内固定不增加固定节段，能很好的恢复伤椎高度，纠正脊柱后凸畸形，达到三平面固定，能有效降低平面四边形效应和悬挂效应，能长时间维持伤椎复位后的位置，无术后伤椎高度再次丢失，后凸畸形复发，甚至断钉、短棒等现象的发生，值得临床上推荐应用。

Curative Effect Analysis on Injured Vertebra Pedicle Screw Internal Fixation Treating Thoracolumbar Burst Fracture 52 Cases

Objective] To discuss the effect of injured pedicle screw internal fixation（PSF） on thoracolumbar burst fracture. Method] Choose 52 cases of such disease above treated for operation in hospital, who all take injured PSF for treatment; compare their visual analog scale（VAS）, compressibility of front and back edges height of injured vertebra, the correction degree of vertebra kyphosis, the changes injured vertebra bone canalis spinalis perching rate before and after treatment, and take American spinal injury association（ASIA） level standard to evaluate the spinal nerve recovery. Result] 52 cases all finished the operation smoothly, all took injured vertebra PSF. All were followed up for over 12-24m. After operation, the patients lumbago and back pain was relieved, the front and back edges of injured vertebra, focal kyphosis and canalis spinalis perching rate were reheved a lot, the spinal nerve function recovered well, in grade 1-2. All cases had no loose or broken internal fixation, the vertebra height was not missing apparently, the kyphosis didn＇t recur or was severer. Conclusion] The said fixation doesn＇t add fixed section, can well recover injured vertebra height, correct spinal kyphosis, reach 3 fixed planes, effectively reduce plane quadrangle efficacy and hanging effect, can long time maintain injured vertebra reposition, without re-missing injured vertebra height, or kyphosis, broken nail, short cane, etc., worth clinical application.