椎体后缘开窗椎体内植骨加椎弓根螺钉系统固定治疗胸腰椎骨折脱位  

Vertebral Rear Window Vertebral Body and Bone Graft and Pedicle Screw Fixation Treatment Thoracolumbar Fracture Dislocation

作　　者：黄方兴 

机构地区：[1]应城市人民医院骨二科,湖北应城432400

出　　处：《中国医药指南》2013年第4期60-61,共2页Guide of China Medicine

摘　　要：目的探讨椎体后缘开窗椎体内植骨加短节段内固定治疗胸腰椎骨折脱位中的运用价值。方法用椎弓根螺钉系统内固定、经椎管于椎体后缘开窗椎体内植骨治疗胸腰椎骨折32例,并进行随访分析,观察神经损伤以及骨折椎体高度的变化和相应节段椎管容积恢复情况。结果除神经损伤ASIA分级为A级的3例无变化外,其余都有不同程度的恢复,骨折椎体前缘高度(%):术前(50.12±14.50),术后(96.3±15.3),1年后随访(95.2±12.60)。椎管受阻狭窄程度:按Wolter分类,术前指数l(10例),指数2(14例),指数3(8例),术后指数0(26例),指数1(6例)。内固定无发生断钉,松动等。结论椎体后缘开窗椎体内植骨加椎弓根螺钉内固定是治疗胸腰椎骨折及脱位的有效方法,为建立脊柱永久的稳定,防止高度丢失及内固定物断裂,在椎弓根螺钉内固定的同时经椎管于椎体后缘开窗椎体内植骨是一种较为方便实用的方法。Objective Discussion on the value of fenestration of the posterior margin of the vertebral body and vertebral body bone graft combined with short segment fixation for the treatment of thoracic and lumbar fracture and dislocation. Method By using pedicle screw system fixation in the posterior margin of the vertebral body, via spinal canal fenestration of the vertebral body bone graft for the treatment of thoracic and lumbar fracture in 32 cases, and follow-up analysis, observation of nerve damage and the height variation of fracture of vertebral body and the corresponding segment of spinal canal volume recovery. Result except 3 cases （the nerve injury is A-level in ASIA grading） have no change, the rest have varying degrees of recovery. The average height of leading edge of fracture of vertebral body（%）： pre-operation 50.12, post-operation 96.3, follow-up after one year 95.2. Stenosis of spinal canal obstruction （according to the Wolter classification）：pre-operation index 1 （10 cases）, pre-operation index 2 （14 cases）, pre-operation index 3 （8 cases）, pre-operation index 0 （26 cases）, pre-operation index 1 （6 cases）. Internal fixation with no broken nails, loosening. Conclusion fenestration of vertebral posterior vertebral body with bone graft and pedicle screw fixation in the treatment of thoracic and lumbar fracture and dislocation is an effective method. For the establishment of spinal permanent stability, prevent the height loss and breakage of internal fixation, pedicle screw internal fixation in the posterior margin of the vertebral body via spinal canal for fenestration of the vertebral body with bone graft is a kind of convenient and practical method.

关 键 词：胸腰椎骨折 椎管 椎体植骨 

分 类 号：R683.2[医药卫生—骨科学]