摘 要：目的：观察AF钉内固定治疗胸腰椎骨折的疗效。方法：对45例胸腰椎骨折行AF钉内固定，对有脊髓损伤症状者，同时行椎管减压(25例)，无脊髓损伤症状者，不再行椎管减压(20例)，37例进行了植骨。结果：本组无死亡，全部出院，平均随访25个月(12～34个月)，对比术前、术后X线侧位片：Cobb角由术前平均28.50恢复到术后2.80(P<0.01)，伤椎前后缘平均高度由术前48.3%和78.5%恢复到术后94.2%和94.4%(P<0.01)，术后神经功能恢复按Frankel分级，除A级2例无恢复外，其余23例均提高1～3级。结论：AF钉具有结构简单，调节方便，有效，手术简化，时间短等优点，对胸腰椎骨折有良好效果。而进钉点的“个体化”，有限的而有效的减压以及植骨是保证疗效，防止并发症的关键。手术时间在伤后1～2周为好。

    关键词： AF钉； 骨折固定术； 胸椎； 腰椎

    Internal Fixation with Atlas Fixator Treating Thoracolumbar Spinal Fracture

    ZENG Shou-li, YANG Hu-lin, SU Guo-qing, et al

    (Chang'an Hospital of Dongguan City, Guangdong Dongguan 523843,China)

    Abstract: Objective: To observe the effect of internal fracture fixatation with AF treating thoracolumbar. Method: 45 cases thoracolumbar spinal injuries were adopted internal fixation with AF nail. 25 cases spinal cord injuries decompressed in spinal canal. 37 cases non- injury in spinal cord were replanted. Result: All the cases were followed rp for 25 moths averagely. They were all discharged and there's no death case. The x- ray were compared before and after opreation. the cobb's corner were recoveried from 28.5° to 2.8°(P<0.01). The average height of injury spinal made a recoveny from 48.3% and 78.5% to 94.2% and 94.4%(P<0.01) respectively. The nerve function were improved 1～3 degreses (23 cases) except 2 cases. A degree withort recovery. Conclusion: AF nail is simple, convenient and effective. It can shorten the operation time and simply the operation. It has good effect on thoracolumbar spinal injury. The key to preventing the complication is the specific point of the nail with the replanted and limited and effective decompression . The suitable time for the operation is 1～2 weeks after the injury. ......