长节段椎弓根螺钉系统治疗上中胸椎骨折脱位的疗效  

Clinical Outcomes of Long-segment Pedicle Screw System in the Treatment of Upper-middle Thoracic Fracture and Dislocation

作　　者：杜晓春[1] 汤同军 郑威伟[1] 罗荣[1] 

机构地区：[1]江苏省句容市人民医院骨科,江苏句容212400

出　　处：《临床医学工程》2010年第12期62-63,共2页Clinical Medicine & Engineering

摘　　要：目的使用长节段椎弓根螺钉系统治疗上中胸椎骨折脱位,探讨该技术的临床疗效。方法自2004年3月至2009年6月应用长节段椎弓根螺钉系统手术治疗上中胸椎骨折脱位病人21例,男16例,女5例。年龄19～46岁,平均34岁。均采用固定伤椎上和下各两个椎体的长节段椎弓根螺钉系统,行减压、复位、内固定加植骨融合术。结果本组无死亡。术后神经功能恢复情况:Frankel A级12例术后无恢复;B级3例术后无恢复1例,恢复至D级2例;C级3例术后恢复到D级2例、E级1例;D级2例术后全部恢复正常;术前1例E级无加重。术前局部后凸畸形平均24.9°,术后早期12.7°,与术前相比,明显改善(P<0.05)。17例获得12个月以上随访的病例,末次随访时有平均2.1°的纠正丢失。结论长节段椎弓根螺钉系统治疗上中胸椎骨折脱位,可满意重建胸腰段的矢状面形态,有效预防术后纠正丢失及内固定松动、断裂。Objective To evaluate the clinical outcomes of long-segment pedicle screw system in the treatment of upper-middle thoracic fracture and dislocation. Methods From March 2004 to June 2009,21 patients were treated with the long-segment pedicle screw system,including 16 males and 5 females. Their age ranged from 19 to 46 years with an average of 34 years. All the patients underwent posterior decompression and pedicle screw instrumentation. The fixation involved two segments above and two segments below the fractured vertebra. Results There was no death. The average local kyphosis was 24.9° at presentation,and improved to be 12.7° after surgery,showing a significant difference（P 0.05） . 17 cases were followed-up for at least 12 months,the final loss of correction was 2.1°. Conclusion The long-segment pedicle screw system in the treatment of upper-middle thoracic fracture and dislocation can achieve satisfactory outcomes with the reconstruction of the sagittal profile.

关 键 词：中上胸椎 骨折 长节段 椎弓根螺钉 纠正丢失 

分 类 号：R687.3[医药卫生—骨科学]