前路Z型钢板加钛网固定治疗胸腰椎爆裂性骨折

目的　探讨前路“Z”型钛钢板结合钛网在治疗严重胸腰椎爆裂骨折中的应用价值。方法　对 32例胸腰椎爆裂骨折伴脊髓或马尾损伤患者 ,采用胸膜外 -腹膜后入路对骨折椎体施行胸腰椎侧前方减压 ,椎体间钛网加自体骨植骨及“Z”型钛钢板固定术。结果　术后随访 1 2～ 32个月 ,平均 1 9. 7个月 ,全部病例椎间植骨均牢固融合 ,脊柱序列正常 ,钢板螺钉无松动。结论　胸腰椎侧前方减压、椎体间钛网加自体骨植骨及“Z”型钛钢板内固定是治疗严重胸腰椎爆裂骨折的理想方法之一

Z-Plate and Titanic Mesh Fixation for Thoracolumbar Burst Fracture by Anterior Approach

Objective To study Z-Plate and titanic mesh internal fixation for severe thoracolumber burst fracture by anterior approach.Methods Thirty two patients with thoracolumbar burst fracture accompanied with spinal cord or cauda equina injury were treated with anterior lateral decompression of thoracolumber fracture by extrapleural and retroperitoneal approach,autograft with titanic mesh between vertebrae and Z-Plate fixation.Results The time of follow up was from 12 months to 32 months (average time was 19.7 months).The result showed that all autograft with titanic mesh between vertebrae fused very well,the alignment of spinal colum was normal,and no plate or screw was loose.Overall outcome was satisfactory.Conclusion Anterior lateral decompression of thoracolumber fracture by autograft with titanic mesh between vertebrae,and Z-Plate fixation is an idea technique for severe thoracolumber burst fracture.