经伤椎椎弓根钉固定治疗胸腰段爆裂性骨折28例分析

目的:探讨后路经伤椎椎弓根钉固定治疗胸腰段爆裂性骨折的可行性和疗效。方法:对28例胸腰段爆裂性骨折采用后路经伤椎椎弓根钉内固定。术前伤椎前缘高度平均为正常高度的52%(35%～70%),Cobb角平均26°(11°～33°),伤椎椎管正中矢状径为正常的67%(30%～90%),均在2周内手术。结果:所有病例均获得随访,平均随访时间13个月(6～22个月),术后伤椎前缘高度恢复至正常高度的95%(89%～100%),Cobb角平均为5.8°(2°～13°),椎管正中矢状径为93%(87%～100%),术后神经功能均有改善,骨折全部愈合,无内固定断裂、松动、矫正丢失等并发症。结论:经伤椎椎弓根钉固定可使骨折获得满意复位,增加脊柱稳定性,减少内固定断裂及矫正丢失等并发症,是治疗胸腰段爆裂骨折的有效方法。

Treatment for thoracolumbar burst fractures with the injured vertebra fixation by pedicle screw:A report of 28 cases

Objective To investigate the feasibility and the clinical outcome of thoracolumbar burst fractures treated with the injured vertebra fixation by pedicle screw.Method Twenty-eight cases of thoracolumbar burst fractures were treated with the injured vertebra fixation by pedicle screw from February 2007 to February 2010.The average height of anterior border was 52%(35% ~ 70%),and the average Cobb angle was 26°(11° ~ 33°),the percentage of midsagitall diameter was 67%(30% ~90%).Operation had been conducted in 2 weeks after fracture.Results All patients were followed up for 6 ~ 22 months(average 13 months),the average height of anterior border was increased to 95%(89%~100%),and the average Cobb angle was 5.8o(2° ~ 13°),the percentage of midsagittal diameter was 93%(89% ~ 100%),The spinal cord function was improved,and all fractures were bony union.There were no internal fixation loosing and breaking,no lost of correcting and other complications.Conclusion It is a feasible and effect method to treat thoracolumbar burst fractures with the injured vertebra fixation by pedicle screw.It can not only reduce vertebra fracture satisfactorily,increase the stability of spine,but also decrease the possibility of breaking nail and correction loss.