椎弓根系统治疗胸腰椎骨折的临床探讨  

Clinical Study on Spinal Pedicle Screw Fixation System for Thoracolumbar Fracture

作　　者：关群[1] 廖乙名[1] 冯世龙[1] 熊小江[1] 骆浩[1] 程军[1] 谢鲤钟[1] 

机构地区：[1]重庆三峡中心医院,404000

出　　处：《现代生物医学进展》2007年第9期1349-1350,共2页Progress in Modern Biomedicine

摘　　要：目的:探讨对椎弓根系统治疗胸腰椎骨折的临床疗效。方法:本组98例均采用后路减压、植骨及椎弓根系统内固定。结果:术中C臂及术后x摄片见植入椎弓根螺钉平行于椎体上下终板95例,3例有4°-6°的成角。伤前后突畸形平均25°,术后矫正至平均4°。术前伤椎压缩50%-75%,术后恢复至89%-95%。获随访1-3年,内固定松动2例,拔钉3例,断钉2例,椎体高度及Cobb角丢失5°-9°有6例。慢性腰痛12例。神经功能除A级有7例未恢复外,其余病例均有1-3级的恢复。结论:后路手术较完善,适应范围广,创伤小,对屈曲压缩型、骨折脱位型的整复及下腰椎的固定优于前路手术。特别强调准确的椎弓根植入技术及有效的植骨融合是保证后路手术脊柱稳定和防止远期并发症的主要手段。Objective： To investigate the clinical therapeutic effect of spinal pedicle screw fixation system in the treatment of thoracolumbar fracture （TLF）. Methods： 98 patients with TLF were performed posterior decompression,bone graft spinal pedicle screw fixation system. Results： The embedded pedicle screws of 95 cases were seen to run parallel with fluctuate endplate of vertebral body on the C-arm during operation and on X-ray projections after operation; 3 cases had 40-60 angulation. The average kyphosis deformity before fracture was 250; postoperative correction reached to 40 on the average.The injured vertebra compression before operation ranged from 50% to 75%, postoperative recovery ,from 89% to 95%. The follow-up period was 1-3 years.2 cases had internal fixation loosening;nails were pulled from 3 cases;nails were broken from 2 cases; 5 cases, 50-90 loss of Cobb angle; 12 cases, chronic lumbodynia.In nerve function, the rest all had recovery of class 1-3 except that 7 cases of class A didn＇t recover. Conclusion： The posterior operations were perfective,which was superior to anterior ones in the reduction of buckling compressed type and bone fracture dislocation type as well as the fixation of lower lumbar vertebrae,with small trauma and wide applying range. So accurate pedicle screw technique of implantation and effective bone fusion can guarantee the stable spinal column in posterior surgery and prevent the postoperative patients from long-term complications.

关 键 词：胸腰椎 骨折 椎弓根系统 治疗 

分 类 号：R681[医药卫生—骨科学]