钉棒及钩棒系统治疗胸腰椎多节段脊柱骨折  

Surgical Treatment of Multiple Thoracolumbar Spinal Fractures by Pedicle Screw/rod and Hook/rod Instrumentation System

作　　者：杨召[1] 廖永兴[1] 刘伟[1] 赵毅[1] 

机构地区：[1]云南省第一人民医院骨科,昆明市650032

出　　处：《中国骨与关节损伤杂志》2005年第7期449-451,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的评价钉棒及钩棒系统治疗胸腰椎多节段脊柱骨折的临床疗效。方法23例多节段胸腰椎骨折患者,后路切开复位,选择性椎管减压,钉棒或钩棒系统内固定及后外侧植骨融合进行手术治疗。其中相邻多节段型13例,非相邻多节段型8例,混合型2例。结果全组病例平均随访14个月,未发现内固定物松动、断离,无继发性脊柱后凸畸形加重。椎体高度由术前平均48·4%恢复至术后平均92·4%。2例完全性及11例不完全性脊髓损伤者,脊髓神经功能获改善。结论在椎管进行充分减压的基础上,钉棒及钩棒系统能有效复位椎体骨折,重建脊柱稳定性,是多节段胸腰椎不稳定性骨折合并脊髓神经损伤后路手术的理想选择。Objective To evaluate, he clinical value of surgical treatment of multiple thoracolumbar spinal fractures by pedicle screw/rod and hook/rod instrumentation system. Methods Fwenty - three cases of multiple injuries involving thoracic and lumbar spine were surgically treated through posterior approach by open reduction, selective vertebral canal decompression, internal fixation with pedicle screw/rod or hook/rod spine instrumentation, and followed by posterior lateral bone graft fusion. Thirteen cases were consecutive fracture, 8 were nonconsecutive and 2 were mixed type. Results All cases were followed up for an average of 14 months. No implant failure and late kyphosis deformity was observed. The average vertebra height was improved from preoperative 48.4 % to postoperative 92.4 % . The postoperative neurological function in two cases of complete spinal cord injuries and 11 incomplete spinal cord injuries were improved.Conclusion Pedicle screw/rod and hook/rod instrumentation system can achieve effective reduction for the fractured vertebrae and simultaneously restore spine stability on the basis of adequate vertebral canal decompression. Posterior spine instrumentation is an ideal choice for surgical treatment of multiple thoracolumbar unstable fractures with or without spinal cord dysfunction.

关 键 词：钉棒 钩棒系统 胸腰椎 多节段脊柱骨折 内固定 后路途径 

分 类 号：R683.2[医药卫生—骨科学]