前路减压植骨及“Z”型钢板内固定治疗胸腰椎爆裂性骨折临床价值探讨

目的探讨前路减压植骨及“z”型钢板内固定在治疗严重胸腰椎体爆裂骨折中的价值。方法对45例胸腰椎爆裂性骨折伴脊髓或马尾损伤患者，采用左侧胸膜外-腹膜后入路对骨折椎体施行侧前方减压，椎体间自体骨植骨及“Z”型钢板内固定术。结果术后随访6～36个月，平均18．7个月，全部患者椎间植骨均融合，脊柱序列正常，钢板、螺钉无松动；瘫痪3例无恢复，其余患者神经功能均有不同程度恢复。结论在条件许可的情况下，前路减压植骨及“Z”型钢板内固定术是治疗脊柱胸腰段爆裂性骨折较好方法。

Anterior decompression,bone graft fusion and Z-plate fixation for thoracolumbar burst fracture

Objective To explore the anterior decompression, bone graft fusion and ＂Z＂ plate fixation in the treatment of severe thoracolumbar burst fracture. Methods A total of 45 patients underwent anterior plating for thoracolumbar burst fracture. The anterolateral decompression,lumbar interbody autologous bone grafting and ＂Z＂ plate fixation were implemented through left extrapleural--retroperitoneal approach. Results Patients were followed up by 6-36 months after operation （ with an average of 18. 7 months）. All patients in this study achieved solid fusion. Spinal sequence was corrected to normal and there was no screw loosening. The neurological function of 3 cases with paraplegia did not improve. The neurological function of the remaining cases was improved in varying degrees. Conclusion Anterior decompression, bone graft fusion and ＂Z＂ plate is a good way in the treatment of spinal thoracolumbar burst fractures.