中国骨伤2011，Vol.24Issue(1)：40-43,4.DOI:10.3969/j.issn.1003-0034.2011.11.012
后路经伤椎置钉短节段复位固定治疗胸腰椎骨折
Surgical treatment of thoracolumbar fractures by using reduction and short-segment pedicle screw at the fracture level
何少奇 1林立兴 1戴鸣海 1唐小君 1汤呈宣1
作者信息
- 1. 瑞安市人民医院骨科,浙江,瑞安,325200
- 折叠
摘要
Abstract
Objective:To evaluate the efficacy,indication and clinical outcome of the treatment of thoracolumbar fractures by using reduction and pedicle screw at the fracture level. Methods:From March 2007 to March 2009,43 patients with thoracolumbar fracture underwent surgical procedure of reduction and pedicle screw at the fracture level,included 31 males and 12 females,with an average age of 36.6 years old ranging from 26 to 56. Of all the patients,there were 34 of single vertebral fracture,4 patients of double vertebral fracture and 5 patients of fracture and dislocation. The spinal cord function was classified by Frankel scale as grade A in 5 cases,grade B in 2 cases,grade C in 9 cases,grade D in 7 cases and grade E in 20 cases. X-rays and CT scans were performed after operation, Cobb angle of the injured vertebral segment, the percentage of vertebral compression,and sagittal diameter stenosis rate of the injured spinal canal were observed for radiographic evaluation. Neurological function was evaluated by the Frankel scale. Results:All patients were followed-up from 12 to 36 months(means 18.3 months).There was no pseudoarticulation, solid bone fusion was achieved in all cases. There were no complications such as loosening and rupturing of internal fixation and so on. Cobb angle of the injured vertebral segment was corrected from preoperative (24.5±9.5 ) degree to postoperative (5.3±5.1) degree and (6.2±4.7) degree at last follow-up. The percentage of vertebral compression was corrected from preoperative (42.3±11.1 )％ to postoperative (5.1 ±5.2)％ and (6.5±5.4)％ at last follow-up. Spinal canal sagittal diameter stenosis rate was corrected from preoperative(34.9±l 1.2)％ to postoperative(5.3±4.7 )％ and (5.4±4.5)％ one year after operation. The spinal cord function was improved 1 to 2 degree in all patients except 3 patients of grade A. Conclusion:Using reduction and short-segment pedicle screw at the fracture level can help the correction of kyphosis,vertebral compression and spinal canal encroachment,and promote the spinal cord function recovery of patients with thoracolumbar burst fracture. It is an effective nethod to treat thoracolumbar fractures by using reduction and short-segment pedicle screw at the fraeture level.关键词
胸椎/腰椎/脊柱骨折/骨折固定术,内引用本文复制引用
何少奇,林立兴,戴鸣海,唐小君,汤呈宣..后路经伤椎置钉短节段复位固定治疗胸腰椎骨折[J].中国骨伤,2011,24(1):40-43,4.
