Dick内固定器治疗胸腰椎骨折脱位并脊髓损伤
作者：马延周
单位：连州市中医院，广东 连州 513400
关键词：脊柱损伤；骨折固定术；髓内；外科手术
中国骨伤000908摘 要：目的对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23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53.3%，Ⅰ级26.7%，0级20%；不完全性脊髓损伤功能恢复Ⅳ级43.5%，Ⅲ级56.3%。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。
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The use of Dick internal fixation apparatus for the treatment of fracture and dislocation of tioracolumbar vertebra combined with spinal cord injury
MA Yan-zhou
(Lianzhou TCM Hospital Guangdong Lianzhou, 513400)
Abstract：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. Results 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.
, 百拇医药
Keywords：Spinal injuries Fracture fixation, intramedullary Surgery, operative
参考文献：
[1]汤华丰.实用脊椎外科学.上海：上海科学普及出版社，1991.284-287.
[2]陆裕朴，胥少汀，葛宝丰，等，实用骨科学.北京：人民军医出版社，1991.798-813.
收稿日期：1998-08-21
修稿日期：1999-08-02, http://www.100md.com
单位：连州市中医院，广东 连州 513400
关键词：脊柱损伤；骨折固定术；髓内；外科手术
中国骨伤000908摘 要：目的对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23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53.3%，Ⅰ级26.7%，0级20%；不完全性脊髓损伤功能恢复Ⅳ级43.5%，Ⅲ级56.3%。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。
, http://www.100md.com
The use of Dick internal fixation apparatus for the treatment of fracture and dislocation of tioracolumbar vertebra combined with spinal cord injury
MA Yan-zhou
(Lianzhou TCM Hospital Guangdong Lianzhou, 513400)
Abstract：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. Results 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.
, 百拇医药
Keywords：Spinal injuries Fracture fixation, intramedullary Surgery, operative
参考文献：
[1]汤华丰.实用脊椎外科学.上海：上海科学普及出版社，1991.284-287.
[2]陆裕朴，胥少汀，葛宝丰，等，实用骨科学.北京：人民军医出版社，1991.798-813.
收稿日期：1998-08-21
修稿日期：1999-08-02, http://www.100md.com