胸腰椎骨折经伤椎椎弓根置钉附加横连固定的临床应用  

Clinical applying of transpedicle fixation via injured vertebrae plus connector for short-segment instrumentation of thoracolumbar compression fracture

作　　者：周志刚[1] 蔡亮[1] 严朝华[1] 李强[1] 付江明[1] 

机构地区：[1]江西省九江市第一人民医院骨科,332000

出　　处：《中国实用医药》2011年第16期17-18,共2页China Practical Medicine

摘　　要：目的观察胸腰椎压缩性骨折经伤椎椎弓根复位附加横连内固定的临床疗效。方法 2008年1月至2010年9月,本院手术治疗胸腰椎压缩性骨折患者17例,男11例,女6例;平均年龄35.2岁。骨折部位:T111例,T127例,L16例,L23例。按ASIA脊髓神经功能障碍分级标准:A级0例,B级2例,C级3例,D级4例,E级8例。附加横连经伤椎和上下相邻椎体椎弓根置钉短节段6钉固定,观察患者康复后,骨折复位的丢失情况和脊柱三维6个方向的活动范围。结果伤椎高度恢复至正常的95.6%。脊柱活动范围接近患者受伤前水平,骨折椎体愈合满意,不完全神经损伤患者手术后脊髓神经功能有1～2级的恢复。无神经损伤及加重等并发症。结论经伤椎椎弓根螺钉固定对骨折直接复位和固定可提高复位质量,附加横连在轴向旋转运动方向上可提供更强的生物力学稳定性。Objective To observe the effect of transpedicle fixation via injured vertebrae plus connector for short-segment instrumentation of thoracolumbar compression fracture. Methods Between January 2008 and September 2010, 17 cases thoracolumbar compression fracture, 11 males and 6 females, were treated in our department. Their average age was 35.2 years old. They fractured vertebrae were as follow： T11 in 1 case, T12 in 7 cases, L1 in 6 cases and L2 in 3 cases. According to the ASIA （American Spinal Injury Association） neurological function grading system, there were 2 grade B, 3 grade C, 4 grade D and 8 grade E. Transpedicular fixation via injured vertebra plus connector （6-screws plus connector construct） were observed for the range of motion in spine and reduced of compression fracture vertebra and corrected of the kyphosis and lateral dislocation after operation. Results The range of motion in spine and reduced of compression fracture vertebra and corrected of the kyphosis and lateral dislocation after operation were as well as before injured in spine. There were no complications. For incomplete neurological injures, improvement of one to two grades was made in neurological functions. Conclusion Transpedicular fixation via injured vertebra can improve the quality of reduction compression fracture. Additionally, transpedicular fixation via injured vertebra plus connector can enhance the biomechanical stability in axial rotation of the short-segment pedicle fixation system.

关 键 词：胸椎 腰椎 压缩性骨折 经骨折椎固定 

分 类 号：R687.3[医药卫生—骨科学]