椎弓根钉内固定治疗胸腰椎骨折的临床观察  

Clinical application of segment short instrument for unstable thoracolumber fractures

作　　者：栗向明[1] 姬凌飞[1] 王传生[1] 朱士永[1] 张新献[1] 陈志勇[1] 

机构地区：[1]苍山县人民医院脊柱外科,277700

出　　处：《泰山医学院学报》2010年第9期670-672,共3页Journal of Taishan Medical College

摘　　要：目的探讨短节段经椎弓根钉复位固定治疗胸腰椎骨折的方法和疗效。方法应用短节段椎弓根钉内固定器械复位固定治疗不稳定性胸腰椎骨折206例,179例行横突间或椎板间植骨融合,平均随访14个月。结果短节段椎弓根钉（Dick除外）复位固定后,伤椎术后椎体高度比和Cobb′s角有显著改善41例后路植骨融合者无断钉、钉松动或矫正度丢失严重现象。按美国脊髓损伤学会（ASIA）神经损伤分级标准评定,134例不完全性损伤患者提高1-3级,15例完全性脊髓损伤部分患者神经功能有所恢复。结论短节段椎弓根钉复位固定治疗胸腰椎骨折有利于恢复神经功能、伤椎高度和生理弧度,而后路植骨融合是预防内固定失败、矫正度丢失和继发性神经功能损害的重要手段。Objective： To study the methods and results for t reatment of unstable thoracolumber fractures with short segmentpedicle instrument.Methods： 206 cases of thoracolumber fractures were reduced and fixed with short sgement pedicle instrument,179cases among them were also fused with bone graft between lamina and transverse process.They were followed up for an average of 14 months.Results： For 134 patients of incomplete spinal cord injury,the ASIA classification was improved up for an average of 1-3 grades.For the rest patients of complete spinal cord injury,the spinal nerve root recovered partially.The rate of compressed vertebral bodies height and Cobb＇angle were significantly improved by short segment pedicle instrument（except Dick）.Conclusion： The treatment of unstable thoracolumber fracture with short segment pedicle instrument helps to recover spinal neurological function,improve the rate of compressed vertebral bodies height and physiological arc.The fusion with bone graft between lamina and transverse process is an important method to prevent implant failure,correction loss,following neurological deficit.

关 键 词：椎弓根器械 胸腰椎骨折 不稳定性 

分 类 号：R687.32[医药卫生—骨科学]