AF固定结合经椎管椎体植骨加硬膜外骨水泥植骨治疗胸腰椎爆裂型骨折  

Treatment of thoracolumbar burst fracture with AF device fixation,vertebral body bone graft via spinal canal and the bone powder graft of the surface dura mater

作　　者：李长虎[1] 黄云[1] 陈华[1] 

机构地区：[1]青海省人民医院,西宁810007

出　　处：《陕西医学杂志》2004年第9期788-790,共3页Shaanxi Medical Journal

摘　　要：目的 :观察 AF固定结合经椎管椎体植骨加硬膜外骨泥植骨治疗胸腰椎爆裂型骨折的疗效。方法 :对 2 7例胸腰椎爆裂型骨折用 AF固定结合经椎管椎体植骨加硬膜外骨泥植骨并进行随访。结果 :Cobb氏角术前平均 2 3°(1 1°～ 3 6°) ,术后平均 5°(3°～ 8°)。伤椎前缘高度术前 (% ) 51 .1 2 (2 4～ 70 ) ,术后 (% ) 95.3 (92～ 1 0 0 ) ,1年后 (% ) 94.7(88～ 98)。椎管受阻狭窄程度按 Wolter分类 ,术前指数 1有 4例 ,指数 2有 1 9例 ,指数 3有 4例。术后指数 0有 2 4例 ,指数 1有 3例。神经功能按 ASIA分级 ,除 1例 A级无恢复外其余有 1～ 3级恢复。结论 :AF固定是治疗胸腰椎爆裂型骨折常用而效果满意的方法 ,结合经椎管椎体植骨加硬膜外骨泥植骨有利于维持椎体高度 ,防止后凸畸形。Objective:To assess the effect of AF device fixation , vertebral body bone graft via spinal canal and the bone powder graft of the surface dura mater. Methods: 27 cases of thoracolumbar burst fracture were treated with AF device fixation, vertebral body bone graft via spinal canal and the bone powder graft of surface dura mater .The variance of the function of nerves and the height of the fractured vertebral body were followed up and analyzed. Results: Cobb's was preoperatively 23 0, (11 0～36 0 ), postoperatively 5 0 (3 0～8 0). The front height of the fractured vertebral body was preoperatively (%) 51.12 (24～70), postoperatively (%) 95.3 (92～100), after one year (%) 94.7 (88～98). According to the Wolter's classification to evaluate the stenosis of spinal canal, 4 cases were index 1, 19 cases 2, 4 cases 3 preoperatively. 20 cases were 0, 3 cases 1 postoperatively. According to ASIA, 1～3 were recovered of the function of nerves except 1 case(A). Conclusion: The AF device fixation was one of the effective, convenient procedures for treatment of thoracolumbar burst fracture. Through vertebral body bone graft and the powder graft of surface dura mater, the height of the fractured vertebral body can be supported and kyphosis can be prevented

关 键 词：椎管 AF固定 胸腰椎爆裂型骨折 硬膜外 椎体 植骨治疗 术前 指数 结论 方法 

分 类 号：R683[医药卫生—骨科学] R681[医药卫生—外科学]