三平面固定治疗胸腰椎骨折的疗效观察

目的 探讨后路三平面椎弓根螺钉内固定系统治疗胸腰椎骨折疗效.方法 对15例胸腰椎骨折采用后路三平面椎弓根螺钉内固定系统复位固定,骨折椎体一侧或双侧椎弓根完整,椎体下半部及下终板无爆裂,在骨折椎体上应用椎弓根螺钉垂直应力方向向前加压,达到椎体应力平衡.随诊6～18个月.结果 在骨折椎体上应用椎弓根螺钉向垂直应力方向加压使骨折椎体移动复位,有效控制正常椎间盘高度的撑开,术后Cobb角及前柱高度恢复良好,无断钉和内固定松脱.结论 有条件地采用后路三平面椎弓根螺钉固定系统治疗胸腰椎骨折能增强内固定牢固性,有利于后凸畸形的矫正和维持矫正效果.

The Result Observation of the Tri-planar Fixation for the Treatment of Thoracic and Lumbar Vertebral Fracture.

Objective To explore the clinical effectiveness the posterior tri-planar pedicle screws internal fixation in the treatment of thoracolumbar fractures. Methods The 15 cases with thoracolumbar fractures were treated with posterior tri-planar pedicle screws internal fixation,The fractural vertebras which unilateral or bilateral pedicle were integrity,or the lower part and inferior endplate of vertebra were no brusting,were applied the ventral stress pedicle screws to compress forward ,reaching the balance of vertebral stress. These cases were followed up 6 to 18 months. Results The above method could enable the fractural vertebras reduction,control the distraction of normal intervertebral discs height availably; In the postoperation,the Cobb angle and the anterior column height had well recovery,there were no broken screw and looseness of the internal fixation. Conclusion In certain conditions,the posterior tri-planar pedicle screws internal fixation in the treatment of thoracolumbar fractures could enhance the stiffness of internal fixation,which still could help to correct the kyphosis and maintain the reduction.