前路减压植骨内固定治疗胸腰椎骨折  

Treatment of thoracolumbar spinal fracture with anterior decompression,titanium rete supporting bone autograft and Z-Plate fixation system

作　　者：刘忠[1] 张绍文[1] 温剑涛[1] 牛喜信[1] 

机构地区：[1]甘肃省中医院脊柱外科,甘肃兰州730050

出　　处：《兰州大学学报（医学版）》2008年第3期78-80,共3页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨前路减压内固定治疗胸腰段脊柱骨折合并脊髓损伤的疗效。方法胸腰段脊柱骨折伴脊髓损伤患者26例,损伤类型有高处坠落伤、车祸伤、重物压伤;脊柱损伤节段T_4 2例、T_5 2例、T_6 2例、T_(10) 3例、T_(12) 8例、L_1 6例、L_2 3例。手术距受伤时间2 h～26 d。手术采用侧前方入路,行侧前方椎管减压、钛网支撑植骨及Z-Plate钢板内固定。结果随访6月～4年,术后椎体间均获骨性融合。24例脊柱生理弧度恢复正常,椎管减压充分,钛网及钢板位置良好。25例患者神经功能有不同程度恢复,Frankel分级平均改善1.2级。无并发症发生。结论前路减压内固定治疗胸腰段脊柱骨折合并脊髓损伤可充分恢复椎体的正常高度与序列,并利用切除的肋骨和减压碎骨块进行植骨,避免取自体髂骨,提高椎体间融合率,以重新获得脊柱的稳定性。Objective To study the advantages of anterior decompression, internal fixation with Z-Plate fixation system and titanium rete supporting bone autograft for thoracolumbar spinal fracture with spinal cord injury. Methods 26 cases with thoracolumbar spinal fracture accompanied by spinal cord injury were analyzed. They were performed anterior decompression and Z-Plate fixation with titanium rete supporting bone autograft. Results The follow-up time was 6 months^4 years. All got intervertebral bony fusion. The function of spinal cord was improved 1.2 bands on the average in all cases according to the Frankel classification. No complication was found. Conclusion Anterior decompression and titanium rete for supporting bone autograft using Z-Plate fixation system may sufficiently utilize the bone in spinal decompression for autograft, avoid autograft of iliac bone, increase the spinal fusion rate and regain spinal stability.

关 键 词：胸腰椎骨折 前路减压 内固定 

分 类 号：R683[医药卫生—骨科学]