胸腰段脊柱骨折经伤椎椎弓根钉固定治疗体会

目的总结胸腰段脊柱骨折经伤椎椎弓根钉固定的临床效果。方法从2008年2月～2011年2月共对60例胸腰段脊柱骨折患者行后路手术治疗,年龄20～72岁,平均39.6岁,男51例,女9例。其中跨伤椎固定38例,经伤椎固定置钉22例。结果本组所有患者均获得随访,随访时间12～36个月,平均20个月。通过对两种手术方法术前术后的伤椎椎体前缘与后缘高度比值和矢状位后凸Cobb角比较,显示经伤椎椎弓根钉固定后,椎体高度恢复和矫正后凸畸形效果好于跨伤椎组(P<0.01)。经伤椎组无内固定松动断裂现象,跨伤椎组发生断钉1例,松动1例。结论胸腰段脊柱骨折行后路椎弓根钉固定是一种有效治疗方法,经伤椎椎弓根钉固定较跨伤椎椎弓根钉固定有较好的复位和固定效果。

Thoracolumbar spine fracture fractured vertebral body and pedicle screw fixation in the treatment of experience

Objective To summarize the thoracolumbar spine fractures by injury pedicle screw fixation clinical. Methods From February 2008 to February 2011, a total of 60 cases of thoracolumbar spine fractures underwent posterior surgery, age 20-72 years, mean 39.6 years, 51 males and 9 females. Which cross the injured vertebral fixed 38 cases, 22 cases of injured vertebral fixed set nail. Results In this group all patients were followed up for 12-36 months of follow-up time, with an average of 20 months. The fractured vertebral body pediele screw fixation through the leading edge of the vertebral body and posterior height ratio and the sagittal Cobb angle two surgical techniques preoperative and postoperative vertebral height restoration and correction convex deformity were better than the cross-injured vertebral group （P 〈 0.01）. The frac- tured vertebral body was no loosening or breakage, cross-fractured vertebral body group and broken nails one cases, loose one cases. Conclusion Of thoracolumbar spine fractures with posterior pedicle screw fixation is an effective treatment, com- pared to cross fracturedvertebral body pedicle screw fixation of fractured vertebral pedicle screw fixed with a good reduc- tion and fixation effect.