AF椎弓根内固定治疗不稳定性胸腰段骨折并截瘫38例疗效观察  

AF Instrumentation for 38 Cases of Unstable Thoracolumbar Fractures with Paralysis

作　　者：彭昊[1] 郭卫春[1] 任岳[1] 刘世清[1] 刘金慕[1] 

机构地区：[1]武汉大学人民医院骨科,武汉430060

出　　处：《医学新知》2003年第3期131-132,139,共3页New Medicine

摘　　要：目的　观察AF椎弓根螺钉内固定治疗不稳定性胸腰段骨折并截瘫的疗效。方法　采用AF椎弓根螺钉内固定结合推移复位法治疗不稳定性胸腰段骨折合并截瘫 38例。结果　Cobb’s角由术前平均 2 3.8°(11°～ 43°)矫正到术后平均 2 .6°(0°～ 8°) ;椎体前、后缘高度由术前 46 %〈2 3%～ 6 8%〉和 70 %〈32 %～ 80 %〉恢复到术后的 92 %〈89%～10 0 %〉与 97%〈94%～ 10 0 %〉。 3者均有显著统计学差异 (P <0 .0 1)。术后随访 6～ 2 8mo,平均随访 10 .5mo ,32例不完全性截瘫患者均有 1～ 3级恢复 ,6例全瘫患者中 ,4例有 1～ 2级恢复。结论　AF椎弓根内固定系统能使突入椎管腔内的伤椎椎体后壁精确复位 ,牢靠固定 ,并使椎管有效减压。但在某些前、后纵韧带完整性已遭破坏的爆裂型骨折、脱位病例 ,推移复位法可作为AF内固定系统的必要补充。Objective To observe the result of AF instrumentation for the treatment of unstable thoracolumbar fractures.Methods 38 cases of unstable thoracolumbar fractures were treated with AF instrumentation.Results Cobb's angle was corrected from 23.8° preoperatively to 2.6° postoperatively; and anterior and posterior heights of compressed vertebral bodies were restored from 46%(23%～68%) and 70%(32%～80%) pretoperatively to 92%(89%～100%) and 97%(94%～100%) postoperatively respectively. There are remarkable statistical differences between the preoperative and the postoperative data.The postoperative follow-up survey was made for 6 to 28 months with an average of 10.5 months. Of the 38 cases, 4 cases progressed 1 to 2 grades in 6 cases with complete paralysis, and other 32 cases with incomplete paralysis progressed 1 to 3 grades.Conclusion AF instrumentation could achieve anatomical reduction and reliable fixation of fractured vertebrae, and effective decompression of spinal cord.Push-reduction could be a necessary supplemental reduction method for AF instrumentation.

关 键 词：AF椎弓根内固定系统 治疗 不稳定性胸腰段骨折 截瘫 疗效 合并症 手术方法 

分 类 号：R687.3[医药卫生—骨科学]