椎弓根螺钉系统治疗无瘫痪胸腰椎爆裂性骨折 (pdf)

    [摘要] 目的 评价椎弓根螺钉系统治疗无瘫痪胸腰椎爆裂性骨折的疗效。方法 自1998～2005年，对50例无瘫痪的胸腰椎爆裂性骨折病人行椎弓根系统内固定术。采用爆裂性骨折的Denis分类。平均年龄为42岁。平均随访时间为3.5年。椎体破坏程度用McCormack的Load shearing classification(LSC)。LSC小于7分(全例)的采用椎弓根螺钉系统的后路固定法。植骨方法除横突间植骨(简称PLF)外，在胸腰椎移行部加有经椎弓根的椎体间植骨(transpedicular bone implantation)。在下位腰椎部加用椎体间植骨(简称PLIF)。结果 局部后凸从术前的平均16.5°改善到3.7°。术后随访(最后复查)时变为7.4°，平均丢失3.7°。结论 椎弓根螺钉系统经后路椎体间植骨，加强前柱的支持是有效的治疗胸腰椎爆裂性骨折方法。

    [关键词] 椎弓根螺钉；胸腰椎爆裂性骨折

    Pedicle screw in treatment of thoracolumbar burst fractures without neurological deficits

    ZHENG Yuan-zhe,CUI Zheng-mo,LI Yong-hao.No.2 Department of Orthopaedics,the Second People’s Hospital of Yanbian,Yanji 133001,China

    [Abstract] Objective To evaluate clinical results of posterior stabilization with instrumentation for thoracolumbar burst fractures without neurological deficit.Methods Fifty patients with burst fractures were classified by Denis’s method,and surgically treated with pedicle screw fixation.The mean age of patients was 42 years.Follow-up periods ranged from six months to four years.Preoperative bony fracture anatomy was analyzed according to the load sharing classification by McCormack.Postoperatively,the amount of correction of kyphotie deformity was examined.A load-sharing score of 7 points or less indicates posterior stabilization with transpedicular bone implantation or PLIF for thoracolumbar fractures.Results Average preoperative kyphotic deformity angle was 16.5&ordm,the mean intraoperative correction angle was 3.7ºand the loss of correction observed at the final follow-up evaluation was 3.7 &ordm.Conclusion Posterior stabbilization with pedicle screw fixation using anterior column support is useful procedures for thoracolumbar burst fractures. ......