56-短節段通用脊柱系統内固定加伤椎内植骨治疗胸腰椎不稳定骨折 三院 蒋国强.doc

短节段通用脊柱系统内固定加伤椎内植骨治疗胸腰椎不稳定骨折 宁波大学医学院附属医院 脊柱外一科 蒋国强 岳兵 卢斌 罗科锋 陆继业 王如林 乐增年 韩成钢 【摘要】 目的 探讨应用短节段通用脊柱系统（USS）骨折内固定系统及伤椎内植骨治疗胸腰椎不稳定骨折的临床疗效。方法 对40例急性单节段胸腰椎不稳定骨折行后路短节段USS骨折内固定系统及伤椎内植骨，对患者手术前后的椎体高度、Cobb’s 角进行比较，观察术后1年内固定材料有无松动、断裂，椎体内及椎板间融合情况，神经功能恢复情况。结果 40 例患者术后1周、1年伤椎前后缘高度比值、Cobb’s角较术前均明显改善，差异有统计学意义（P＜0.05），术后1周与1年上述指标比较差异均无统计学意义（P＞0.05），术后1年复查未见内固定物松动、断裂，椎体内及椎板间均达到骨性融合，有5例神经功能较术前好转。 结论 短节段USS骨折内固定系统及伤椎内植骨治疗胸腰椎不稳定骨折，椎体内及椎板间植骨融合率高，能有效防止术后矫正丢失及内固定失败。 【关键词】 胸腰椎不稳定骨折；短节段USS内固定；伤椎内植骨 Treatment of thoracolumbar fractures with short-segmental fixation using Universal Spine System JIANG Guo-qiang,YUE Bing,LU Bin,LUO Ke-feng,LU Ji-ye,WANG Ru-lin,LE zeng-nian, HAN Cheng-gang (The Affiliated Hospital Of Ningbo University Medical School Department 1 of spine surgery) [Abstract] Objective To evaluate the clinical effect of the method in treatment of thoracolumbar unstable fractures with posterior short-segment Universal spine system(USS) and bone grafted into the fractured vertebra. Method 40 cases of acute and single segmental thoracolumbar unstable fracture were treated by using posterior short-segment USS and grafting bone into the fractured vertebra, then to follow up and contrast the vertebral height and Cobb angle pre- and post-operation. We observed the conditions of fixed material, fusion, and recovery of neurological function after 1 year post-op. Results The ratios of vertebral height and Cobb’s angle improved obviously after operation, and the data showed there was no statistical significance between 1 week and 1 year post-op. After 1 year post-op,we found that there weren’t any fixed material loosened or fractrued, bone fused well not only in the vertebra body, but also between the vertebral plates, 5 cases had recovered in neurological function. Conclusions In treatment of thoracolumbar unstable fractures, the method of using posterior short-segment USS and grafting bone into the fractured vertebra can obtain excellent fusion, maintain the correction effect and