后路复位长节段固定植骨融合治疗胸腰椎骨折脱位  

Posterior surgery with long-segment fixation and fusion for thoracolumbar fracture dislocation

作　　者：苏明海[1] 张勇[1] 徐院生[1] 赵红军[1] 

机构地区：[1]解放军第81医院骨科,江苏南京210022

出　　处：《临床骨科杂志》2011年第4期376-378,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨后路复位长节段固定植骨融合术治疗胸腰段骨折脱位的临床效果。方法采用后路长节段椎弓根螺钉固定后路植骨融合术治疗18例胸腰椎骨折脱位患者。结果 18例均获随访,时间6~24个月。椎体脱位及旋转、成角移位均完全纠正。Cobb角从术前平均29.9°±3.2°恢复至术后平均4.8°±3.2°、末次随访时平均6.6°±4.0°;伤椎椎体高度从术前平均54.3%±8.6%恢复至术后平均92.8%±8.1%、末次随访时平均91.2%±9.4%。神经功能Frankel分级：A级2例中1例恢复至B级,1例无改善;B级3例中恢复至D级2例,C级1例;C级6例中恢复至D级3例、E级3例;D级6例均恢复至E级;E级1例仍为E级。未见内固定断裂、松动及螺钉位置不当。结论后路复位长节段固定植骨融合术是治疗胸腰段骨折脱位的良好方法。Objective To analyze the results of posterior surgery with long-segment fixation and fusion for thoracolumbar fracture dislocation.Methods A total of 18 cases with thoracolumbar fracture dislocation were treated with posterior long-segment fixation and fusion.Results All cases were followed up for 6~24 months postoperatively.Thoracolumbar fracture dislocation got good reduction.Cobb angle was restored from（29.9±3.2） degrees preoperatively to（4.8±3.2） degrees postoperatively,and to（6.6±4.0） degrees at last follow-up.The anterior edge height of the fractured vertebrae was restored from（54.3±8.6）% preoperatively to（92.8±8.1）% postoperatively,and to（91.2±9.4）% at last follow-up.According to Frankel grading system,2 at Grade A were improved to Grade B in 1,1 got no improvement;3 at Grade B were improved to Grade D in 2 and Grade C in 1;6 at Grade C were improved to Grade D in 3 and Grade E in 3;6 at Grade D all were improved to Grade E;1 at Grade E remained in Grade E.No internal fixation loosening or breakage or misplaced pedicle screw was noted.Conclusions Posterior surgery combined with long-segment fixation and fusion is an effective treatment for thoracolumbar fracture dislocation.

关 键 词：胸椎骨折 腰椎骨折 脊柱融合术 脱位 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]