比较通用型脊柱内固定与AF系统治疗单节段胸腰椎骨折  

General spine system versus AF system fixation for the treatment of single-segment thoracolumbar fracture

作　　者：房体刚 樊世峰 白云飞 

机构地区：[1]六盘水市水矿总医院骨二科,贵州省六盘水市553000

出　　处：《中国组织工程研究》2012年第35期6632-6635,共4页Chinese Journal of Tissue Engineering Research

摘　　要：背景:椎弓钉内固定系统较多,主要有AF、通用型脊柱内固定系统、RF等,但各自存在一定的不足。目的:比较通用型脊柱内固定系统与AF系统治疗胸腰椎骨折临床效果。方法:采用随机数字表法将110例胸腰椎骨折的患者分为通用型脊柱内固定组和AF内固定组。于内固定后1周,3个月,1年随访,比较两组患者内固定前后伤椎椎体前缘高度、Cobb角、脊髓神经损伤Frankel分级及内固定后X射线片结果。结果与结论:内固定后1周及1年随访,两组椎体高度百分比和Cobb角差异无显著性意义。两组内固定后1周椎体前缘高度百分比及后凸Cobb角明显好于内固定前(P<0.01),两组内固定后1周与内固定后1年比较差异无显著性意义。两组患者内固定后按Frankel分级神经功能恢复方面比较差异无显著性意义。内固定后并发症通用型脊柱内固定系统组1例1枚椎弓根螺钉断裂,AF内固定组2例断钉,3例断棒,差异有显著性意义。提示通用型脊柱内固定系统和AF系统治疗单节段胸腰椎骨折均能取得优良的临床疗效。相比通用型脊柱内固定系统,AF系统术后断钉或棒较多,不能用于多节段固定。BACKGROUND： There are many pedicle screw systems, including AF system, general spine system and RF system fixation, but each of them has their disadvantages. OBJECTIVE： To compare the outcome of general spine system versus AF system fixation for the treatment of thoracolumbar fracture. METHODS： 110 patients with thoracolumbar fracture were divided into general spine system group （n=56） and AF system group （n=54） randomly. At 1 week, 3 months and 1 year follow-up after fixation, the anterior vertebral height, Cobb angle, Frankel grading of spinal cord injury and X-ray results after internal fixation were compared between two groups. RESULTS AND CONCLUSION： There was no significant difference of the percentage of vertebral height and Cobb angle between two groups at 1 week and 1 year follow-up after fixation. At 1 week after fixation, the percentage of anterior vertebral height and Cobb angle were better than those before fixation （P 0.01）, and there was no significant difference between two groups at 1 week and 1 year after fixation. According to the Frankel grading, there was no significant difference of the neurological function recovery between two groups after fixation. As for the postoperative complications, there was 1 case of one pedicle screw breakage in general spine system group, 2 cases of nail breaking and 3 cases of rod breaking in AF system group, and there was significant difference. Thoracolumbar fracture can be treated successfully with general spine system and AF system fixation. Compared to general spine fixation system, AF system has more nail breaking and rod breaking and cannot be used for multi-section fixation.

关 键 词：胸腰椎骨折 内固定 通用型脊柱内固定系统 AF系统 椎体前缘高度 Cobb角 术后断钉 多阶段固定 远期功能 椎弓根螺钉断裂 

分 类 号：R318[医药卫生—生物医学工程]