后路椎管减压短节段椎弓根内固定治疗胸腰椎爆裂骨折合并脊髓损伤

目的观察后路椎管减压、短节段椎弓根螺钉内固定治疗胸腰椎爆裂性骨折合并脊髓损伤的疗效。方法对2005年以来47例胸腰椎骨折患者采用后路椎管减压、短节段椎弓根螺钉内固定、椎板植骨治疗，术后进行临床和影像学随访。结果本组病例均获得随访，平均随访18．5个月。骨折椎体高度明显恢复，伤椎前、后缘高度术前为（35±8）％、（68±15）％，术后恢复至（94±6）％和（98±6）％。手术前后Cobb角由260±60矫正为4．6°±1．5°。2例神经完全损伤，神经症状未见明显改善外，其余不完全损伤患者ASAI分级较术前均有Ⅰ级或Ⅰ级以上的恢复。结论后路短节段椎弓根内固定术治疗胸腰椎爆裂骨折发挥了手术复位和固定的双重作用，临床疗效满意，骨性愈合率高。

Posterior spinal decompression and short segment pedicle fixation for the treatment of thoracolumbar burst fracture with spinal cord injury

Objective To observe posterior lumbar decompression and short segment pedicle screw fixation for the treatment of thoracolumbar burst fractures. Methods From 2005, Forty - seven patients with thoracolumbar fracture were treated by posterior lumbar decompression, short segment pedicle screw fixation and laminar bone grafting. Postoperative clinical and radiological follow - up were done. Results The patients were followed up for an average time of 18.5 months. Both front and back edge of the fractured vertebral height restored obviously, which were improved from preoperative（35 ± 8 ）% and （68± 15 ） % to postoperative （94 ± 6） % and （98 ± 6 ） %, respectively. And the Cobb angle was correc- ted from 26°±6° to 4.6°± 1.5°. Two cases of complete nerve injury had no significant improvement neurological symptoms, the ASAI classification of the remaining patients with incomplete injury was im- proved more than I level. Conclusions Posterior short - segment pedicle screw fixation for the treatment of thoracolumbar burst fracture exerted the double function of reduction and fixation, with satisfactory clinical efficacy and high healing rate.