椎弓根短节段内固定器治疗胸腰椎骨折及腰椎滑脱症

目的：运用5种椎弓根短节段内固定器（Pedicle short segment fixation,PSSF）（Dick,RF,SF,Steffee,APF）治疗胸腰椎骨折及腰椎滑脱症，并观察其临床效果。方法：采用PSSF治疗57例胸腰椎骨及腰椎滑税症。随访总结手术疗效、术后并发症以及手术失误原因。结果：随访6－60个月，平均15个月，疗效满意，优良率80％；主要并发症有：螺钉位置不当、断钉、钉松动、钉杆连接松动、植骨不融合、再度失稳等，发生率29．8％。结论：（1）PSSF较适用于治疗胸腰椎骨折及腰椎滑脱症；（2）并发症发生率与手术操作有直接的关系。并认为各种RSSF自有特点，只有充分理解其设计原理，准确应用，操作合理时才能达到其设计的复位、固定目的。

Clinical Application of PSSF for Thoracolumbar and Spondylolisthesis

Objective: To analyse the clinical application of PSSF for thoracolubar and spondylolisthesis,and analyse the main surgery complication. Methods: From 1993-1999, five kinds of PSSF (Dick,SF,RF,Steffee, APF) wre used to treat 57 cases thoracolumbar fracture and spondylolisthesis. Complications and failures of surgeries were sum marzied. Results: 57 cases were fellow up over six months (6- 60months),the average follow-up is 15 months. The rate of excellent and good result were 80%. The result is satisfactery,The main surgery compilication are malposition of screw, screw loosen, broken, devices loosen, bone graft failed, spinal stability lost again, etc. The rate of surgery complication is 29%. Conclusions: 1) It is better for clinical application totreat thoracolumbar and spondylolisthesis; 2 )Complications are related directly with the inexact operation of using the devises,of the five kinds of PSSF,each device has a special character,it must be deeply understand about the designaim,onal it be used in exactly right way,it can provide a excellent abillity of reduction and spinal stability.