胸腰椎骨折经伤椎椎弓根置钉附加横连固定临床应用

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1、胸腰椎骨折经伤椎椎弓根置钉附加横连固定临床应用【摘要】目的观察胸腰椎压缩性骨折经伤椎椎弓根复位附加横连内固定的临床疗效。方法2008年1月至2010年9月，本院手术治疗胸腰椎压缩性骨折患者17例，男11例，女6例；平均年龄35.2岁。骨折部位：T�11�1例，T�12�7例，L�1�6例，L�2�3例。按ASIA脊髓神经功能障碍分级标准：A级0例，B级2例，C级3例，D级4例，E级8例。附加横连经伤椎和上下相邻椎体椎弓根置钉短节段6钉固定，观察患者康复后，骨折复位的丢失情况和脊柱三维6个方向的活动范围。结果伤椎高度恢复至正常的95.6%。脊柱活动范围接近患者受伤前水平，骨折椎体愈合满意，

2、不完全神经损伤患者手术后脊髓神经功能有1~2级的恢复。无神经损伤及加重等并发症。结论经伤椎椎弓根螺钉固定对骨折直接复位和固定可提高复位质量，附加横连在轴向旋转运动方向上可提供更强的生物力学稳定性。【关键词】胸椎；腰椎；压缩性骨折；经骨折椎固定Clinicalapplyingoftranspediclefixationviainjuredvertebraeplusconnectorforshort-segmentinstrumentationofthoracolumbarcompressionfracture6ZHOUZhi-gang，CAILiang,YANChao-hua，LIQian

3、g,FUJiang-ming.DepartmentofOrthopaedics，TheFirstPeople’sHospitalofJiujiangCity，Jiangxi，332000，China【Abstract】ObjectiveToobservetheeffectoftranspediclefixationviainjuredvertebraeplusconnectorforshort-segmentinstrumentationofthoracolumbarcompressionfracture.MethodsBetweenJanuary2008andSeptember2010

4、,17casesthoracolumbarcompressionfracture,11malesand6females,weretreatedinourdepartment.Theiraverageagewas35.2yearsold.Theyfracturedvertebraewereasfollow:T�11�in1case,T�12�in7cases,L�1�in6casesandL�2�in3cases.AccordingtotheASIA(AmericanSpinalInjuryAssociation)neurologicalfunctiongradingsystem,ther

5、ewere2gradeB,3gradeC,4gradeDand8gradeE.Transpedicularfixationviainjuredvertebraplusconnector(6-screwsplusconnectorconstruct)wereobservedfortherangeofmotioninspineandreducedofcompressionfracturevertebraandcorrectedofthekyphosisandlateral6dislocationafteroperation.ResultsTherangeofmotioninspineandr

6、educedofcompressionfracturevertebraandcorrectedofthekyphosisandlateraldislocationafteroperationwereaswellasbeforeinjuredinspine.Therewerenocomplications.Forincompleteneurologicalinjures,improvementofonetotwogradeswasmadeinneurologicalfunctions.ConclusionTranspedicularfixationviainjuredvertebracan

7、improvethequalityofreductioncompressionfracture.Additionally,transpedicularfixationviainjuredvertebraplusconnectorcanenhancethebiomechanicalstabilityinaxialrotationoftheshort-segmentpediclefixationsystem.【Keywords】Thor