Dick内固定器治疗胸腰椎骨折脱位并脊髓损伤  

The use of Dick internal fixation apparatus for the treatment of fracture and dislocation of thoracolumbar vertebra combined with spinal cord injury

作　　者：马延周 

机构地区：[1]连州市中医院,广东连州513400

出　　处：《中国骨伤》2000年第9期531-532,共2页China Journal of Orthopaedics and Traumatology

摘　　要：对 38例胸腰椎骨折脱位并脊髓损伤的患者采用Dick内固定器固定脊椎的方法治疗 ,评价该手术疗法的临床效果。方法　 38例中完全性脊髓损伤 15例 ,不完全性脊髓损伤 2 3例。根据脊椎的棘突与椎体在X线片上的关系 ,在术中确定Dick钉在关节突处进针点上的矢状面和水平面上的进针方向 ,未用X线机辅助。在减压复位后 ,用Dick内固定器把受损脊椎固定。结果　脊椎和椎体复位率达 83 5 % ,完全性脊髓损伤功能恢复Ⅱ级 5 3 3% ,Ⅰ级 2 6 7% ,0级 2 0 % ;不完全性脊髓损伤功能恢复Ⅳ级 43 5 % ,Ⅲ级 5 6 3%。结论　在手术中不用X线机辅助 ,根据确定的矢状面和水平面上的进针方向 ,用Dick内固定器固定受损的胸腰椎 ,是治疗胸腰椎骨折脱位合并脊髓损伤的一种有效的手术治疗方法。Objective To review the results of treatment using Dick internal fixation apparatus for the treatment of fracture and dislocation of thoracolumbar vertebra combined with spinal cord injury. Methods Of the 38 cases,complete spinal cord injuries occurred in 15 and partial spinal cord injuries occurred in 23.The directions of insertion on the articular process in the sagittal plane and horizontal plane were determined according to the relationship between the spinous process of vertebra and vertebral body in the X ray film.After decompression and reduction,the injured vertebra was fixed with Dick′s internal fixation apparatus.Intra operative,X ray monitoring were not used.[HT5”H]Results [HT5”SS]The reduction rate of vertebra and vertebral body was 83.5%.The neural function of 53.3% of complete spinal cord injured cases recovered to Ⅱ degree,26.7% to Ⅰ degree and 20% had no improvement.The neural function of 43.5% of partial spinal cord injury cases recovered to Ⅳ degree,56.3% to Ⅲ degree.Conclusion The use of Dick′s internal fixation apparatus on the injured thoracolumbar vertebra according to the insertion point in sagittal and horizontal plane without X ray morintoring is an successful method for the treatment of this condition.

关 键 词：脊柱损伤 髓内骨折固定术 外科手术 治疗 

分 类 号：R683.205[医药卫生—骨科学]