钛笼加椎弓根固定治疗腰椎骨折

目的 评价钛笼加椎弓根系统在治疗腰椎椎体骨折中的临床应用疗效.方法 13例腰椎爆裂性骨折病人,行椎体全切及椎管减压术,并用钛笼及碎骨植骨行椎体间融合术,腰椎用椎弓根钉作内固定.结果 术后患者可矫正脊柱畸形,恢复椎体间正常高度,可早期功能锻炼.按ASIA神经功能分级,神经功能9例出现恢复,并有1、2级的提高,4例完全无恢复.术后1 a X线检查出现椎体融合.结论 椎弓根钉内固定加钛笼用于腰椎骨折可有效建立腰椎的稳定性,彻底解除对脊髓的压迫.钛笼可为植骨处提供坚强和稳定的支撑,可防止断钉等并发症发生,又利于早期功能锻炼.该方法创伤较小,植骨量较大,利于植骨融合.

Titanium mesh cage and pedicle screw instrumentation used for lumbar burst fracture

[Objective] To evaluate the clinical efficacy of the treatment of lumbar burst fracture with the titanium mesh cage and pedicl screw instrumentation. [Methods] 13 patients with lumbar burst fracture were treated by vertebral body excision and decompression spinal canal stenosis, using titanium mesh cage for vertebral body fusion. Lumbar vertebral burst fractures were fixed by pedicle screw instrumentation. [Result] The operative reduction had an satisfactory effect on the vertebral angle and height between vertebral bodys. According to the ASIA grade, there was no change in the neurological function of 4 cases. The ASIA grade in other 9 cases was increased for 1-2 grades. The bone in titanium mesh cage was union in followed up a year. [Conclosion] Application of combining pedicles screw fixation and titanium surgical mesh cage can establish stablility of spine and relieve compression of spinal canal stenosis. The titanium mesh cage with autograft bone can provide iron and stable support and reduce the possibility of breaking nail and other complication. It can enable patients do function exercise as early as possible. It is small invasive method of using large structural autografts for these reconstructions and benefit to vertebral body fusion.