椎管减压椎体植骨椎弓根螺钉内固定治疗胸腰椎爆裂骨折56例报告  

56 Case Burst Fractures of Thoracolumbar Vetebra Treated by Vertebral Canal Posterior Wall Decompressive Operation Combining Pedicale Screw Fixation

作　　者：徐本明[1] 鹿洪辉[1] 史亚民[2] 

机构地区：[1]武警北京总队第三医院骨科,北京10039 [2]解放军总医院第一附属医院骨科

出　　处：《中国伤残医学》2008年第4期8-10,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:观察后路椎管减压,椎体植骨加椎弓根螺钉内固定治疗胸腰椎爆裂性骨折的疗效。方法:对2002年以来56例胸腰椎骨折病人采用后路椎管减压,椎体植骨加椎弓根螺钉内固定治疗。结果:全部病例得到随访48例,随访平均20个月(6个月～62个月),其中29例脊髓不全损伤患者Frankel分级提高1级～3级(平均1.8级)。A级16例有2例恢复到B级,1例恢复到C级,其余患者部分术后感觉平面下降或下肢感觉部分恢复,运动功能无明显改善。术后遗留轻度腰背痛5例,有2例出现轻度神经根损伤症状,1例螺钉松动,无1例发生感染。随访病例均行X片检查,后凸角由术前平均28°(11°～35°)矫正到术后10°(0°～15°),椎体前缘高度矢状径指数术前32°(15°～55°),恢复到术后88°(72°～100°)。结论:后路椎管减压,椎体植骨加椎弓根螺钉内固定治疗胸腰椎爆裂性骨折是一种较理想的手术方法。此方法操作简单、安全,解除神经及硬膜囊压迫的同时扩大了椎管,杜绝了继发性椎管狭窄,增加了脊柱稳定性,值得推广。Objective： To observe therapeutic efficacy of bone grafting with vertebral canal posterior wall decompressive operation combining pedicle screw fixation in treating burst fracture of thoracolumbar vertebra. Methods： 56 patients diagnosed as burst fracture of thoracolumbar vertebra were cured by bone grafting with vertebral canal posterior wall decompressive operation combining pedicle screw fixation since 2002. Result： For average 20 months（6-62 months） following up, satisfactory recovery of vertebral body＇s altitude, ideal correction of cobb＇s angle were observed. Average 1.8 （1-3） grade recover was observed in 29 cases with pero--damage of spinal cord. Among 16 cases of pre-operative A degree, 2 cases were recovered to B degree, 1 case to C degree according to Frankel classification and no remarkable recoveries were observed in the other cases. Only 5 cases remained tiny lumbodorsal pain after operation , 2 cases compression in nerve roots and 1 case of loosening of screw were detected. Also no infections were detected. Conclusion： It is an ideal operation for bone grafting with vertebral canal posterior wall decompressive operation combining pedicle screw fixation to treat burst fracture of thoracolumbar vertebra, it is a simple and safe operative techpique to entirely decompress in duramater and nerve roots and enlarge bore of vertebral canal, therefore eliminating secondary spinal stenosis, also increase spinal stability.

关 键 词：胸腰椎 爆裂性骨折 椎弓根螺钉 

分 类 号：R681.54[医药卫生—骨科学]