应用ALPF内固定系统治疗胸腰椎爆裂骨折并不全瘫的临床报告_医学论文.docVIP

应用ALPF内固定系统治疗胸腰椎爆裂骨折并不全瘫的临床报告_医学论文 应用ALPF内固定系统治疗胸腰椎爆裂骨折并不全瘫的临床报告_医学论文 作者：沈明理 李林 孔庆元 张勤义 【摘 要】 目的 探讨胸腰椎爆裂骨折并不全截瘫的APLF内固定治疗及早期手术的必要性。方法 36 例胸腰椎爆裂骨折并不全截瘫患者，受伤后4～14 h接受手术，均行ALPF内固定，恢复椎体高度，椎板切除减压、植骨，并随访。结果 术后随访6～18 个月，平均11 个月，所有患者压缩的椎体基本恢复正常。椎体骨块向后突入致硬脊膜受压病例中33 例完全恢复，3 例未能完全恢复，恢复率达90％。神经功能检查按Frankel法评定，33 例不全截瘫患者均有1～3 级恢复，恢复率91.6％，能生活自理，3 例无明显恢复（受伤6 h后接受手术）。结论 ALPF内固定是治疗胸腰椎爆裂骨折并不全截瘫的比较完美的内固定系统。早期手术是治疗胸腰椎爆裂骨折并不全截瘫的有效方法。准确的骨折复位、充分的椎管减压、椎弓根螺钉的准确植入及局部冷疗亦是手术成功的关键重要的。 【关键词】 内固定；胸腰椎骨折；脊髓损伤 [Abstract] Objective To approach the necessity of treatment of thoracic and lumber vertebrae burst fracture and incomplete paraplegia by Arctrack private lock pedicle orthopedics fixation system（ALPF）and the early surgery. Methods 36 cases,all cases was treated by surgical treatment in 4～14h of injured,All cases is treated by using ALPF to fix、recove vertebral body height、laminectomy for decompression、bone graft and all the cases were followed-up. Results All the patients were followed-up for 6 to 11 months,the average 11 months,vertebral body height of all patients was restored was restored basically normally.the positiong of bone block enter vertebral canal and to oppress spinal dura mater of 33 cases the was complete restoration,3 cases wasn’t complete recovery,the recovery rate reaches 90％、all the fracture is bone union.The never functional check according to the Frankel standard,33 cases has 1～3 levels to restore,the recovery rate reaches 91.6％，basic can look after itself,after 3 examples restore not obviously(they was treated by surgical treatment after 6h of injured). Conclusion Arctrack private lock pedicle orthopedics fixation system is perfect to theat thoracic and lumber vertebrae Burst fracture and Incomplete paraplegia.The early operation is effectiveThe accurate bone fracture replacement、the full decompress、accurate implant pedicle of vertebral arch screw and part cold treatment is important for this surgical treatment. [Keywords] fixation thoracic and lumber vertebrae bur