腰椎多节段椎弓根及椎体骨折伴腰椎滑脱的治疗  

Management of multiple segment lumbar pedicle and vertebral body fractures combined with spondylolisthesis

作　　者：叶晓健[1] 何海龙[1] 谢宁[1] 许国华[1] 席炎海[1] 李家顺[1] 贾连顺[1] 袁文[1] 

机构地区：[1]上海第二军医大学附属长征医院骨科,200003

出　　处：《中华创伤杂志》2009年第8期687-689,共3页Chinese Journal of Trauma

摘　　要：目的评价多节段腰椎椎弓椎体骨折伴滑脱经伤椎椎弓根固定复位和前路钉棒固定后的神经功能与影像学结果。方法选择2002年1月-2007年12月我科收治的腰椎多节段椎弓根椎体骨折脱位患者12例。采用后路经伤椎椎弓根螺钉和前路钉棒固定手术给予复位固定。结果所有患者随访24～30个月（平均26个月）。所有12例患者均有不完全神经损伤，术后至少改进了一个Frankel分级。经伤椎椎弓根骨折处的螺钉固定获得较好的复位。随访期间没有发现螺钉断裂。结论不稳定腰椎多节段椎弓根椎体骨折伴神经损伤可以通过后路有选择性的经骨折椎弓根螺钉固定及前路钉棒系统固定来获得良好的复位和维持。Objective To evaluate neurofunctional and radiographic results of transpedicular screw fixation reduction and anterior column fixation with use of screw-rod system in treatment of muhiple segment lumbar pedicle and vertebral body fractures combined with spondylolisthesis. Methods A consecutive series of 12 patients with unstable multiple segment lumbar pedicle fracture, vertebral body fracture, spondylolisthesis and neurologie deficit were managed with posterior transpedieular screw fixation including fractured pedicle and anterior screw-rod fixation instrumentation from January 2002 to December 2007. Results Patients were followed up for 24-30 months （ mean 26 months ）. All the patients with incomplete neurologic deficits got improvement by at least one Frankel grade. Transpedicular screw brought satisfactory reduction. At the time of the latest follow-up, no screw breakage occurred. Conclusions Excellent reduction of unstable multiple segment lumbar pedicle fractures combined with spondylolisthesis can attain better reduction and maintenance by means of selective pedicle screw fixation via fractured pediele and anterior screw-rod instrument.

关 键 词：脊柱骨折 腰椎 椎弓根 骨折固定器 

分 类 号：R687.3[医药卫生—骨科学]