脊柱外固定复位器在胸腰椎骨折的应用  

Application of external spinal fixator and reductor for treating thoracolumbar fracture

作　　者：金正帅[1] 王道新[1] 范卫民[1] 吴廼庆 

机构地区：[1]南京医科大学第一附属医院骨科,210029

出　　处：《江苏医药》2005年第2期102-104,F005,共4页Jiangsu Medical Journal

摘　　要：目的应用脊柱外固定复位器治疗胸腰椎骨折.方法自行设计研制脊柱外固定复位器,器械由经皮椎弓根钉和支架构成.临床应用127例,其中屈曲压缩型骨折37例,爆裂骨折81例,屈曲牵张骨折9例.结果随访2.5～7年,平均5年2个月.127例术后椎体高度明显恢复,椎体前缘高度丧失度术前(41.00±16.73)%,术后(2.50±2.97)%;椎体后缘高度丧失度术前(8.00±10.65)%,术后(6.70±1.32)%.脊柱后凸畸形角显著减小,术前(19.00±7.09)度,术后(6.79±3.78)度.81例爆裂骨折术后椎管矢径增大,从术前(7.00±1.75) mm增至术后(13.00±3.73) mm.术前、术后测值比较均有显著性差异(P＜0.01).27例神经损伤恢复,其中15例恢复正常,10例部分恢复,2例无恢复.115例术后恢复正常生活工作,11例能进行日常生活及轻工作,1例日常生活困难需人照料.结论临床应用脊柱外固定复位器治疗胸腰椎骨折获得良好疗效.Objective To treat thoracolumbar fracture with minimal invasion.Methods The external spinal fixator and reductor had been designed and made.It consists of percutaneous pedicle screws and a frame.Of 127 patients, 37 cases were with flexion compression fracture,81 cases burst fracture,flexion distraction fracture in 9 cases.Results The follow-up periods were 2.5～7years.The height of vertebral bodies was increased obviously(the loss degree of anterior height) from(41.00±16.73)% before operation to(2.50±2.97)% after operation and posterior height from(8.00±10.65)% to (6.70±1.32)%.The angle of kyphosis was decreased from(19.00±7.09)degree before operation to(6.79±3.78)degree after operation.The sagital diameters of vertebral canal were increased in 81 cases of burst fracture[from(7.00±1.75)mm before operation to(13.00±3.73)mm after operation].The above preopeerative and postoperative measurements were significantly different(P<0.01).The conditions of neural injury were completely recovered in 15 cases,partially recovered in 10 cases and no change in 2 cases after operation.115 patients recovered normal living and working,11 patients can undertake daily living and light working,1 patient had difficultly daily living and needed to be taken care of.Break screw occurred in 1 case and tract infection in 2 cases.There was no neural injury complication.Conclusion The good effects were obtained in the application of external spinal fixator and reductor in treating thoracolumbar fracture.

关 键 词：术后 脊柱 术前 胸腰椎骨折 外固定 临床应用 治疗 恢复 牵张 畸形 

分 类 号：R683[医药卫生—骨科学] R681[医药卫生—外科学]