胸腰椎骨折AF钉系统内固定的应用.docVIP

胸腰椎骨折AF钉系统内固定的应用 　　作者：李得春 　(青海医学院附属医院骨科，青海西宁 810001) 　　摘要: 目的 总结43例胸腰椎体骨折的治疗经验和疗效。 方法 回顾分析我科1999年4月～2003年8月收治的43例胸腰椎体骨折手术患者临床资料，其中高处坠落伤34例，车祸伤6例，砸伤3例;损伤椎体:T 9 1例，T 10 1例，T 11 2例，T 12 13例，L 1 15例，L 2 5例，L 3 4例，T 11 、L 1 双椎体1例，T 12 、L 1 双椎体1例。 结果 43例中37例获得连续随访，随访时间:6个月～3年。椎体形态的恢复Cobbs角由术前平均27.45°(17～52°)恢复到术后平均5.3°(0～15°);椎体前缘高度由术前平均56%(15%～77%)恢复到术后89%(62%～100%)。13例有神经症状的患者，其神经损伤ASIA分级平均提高1～3级。 结论 认为AF钉内固定胸腰椎体骨折是一种有效方法，掌握恰当的椎体固定方法和手术时机，椎板植骨是患椎椎体稳定及神经损伤恢复的有效措施。 　　关键词: 胸腰椎骨折;内固定 　　Treatment of thoracolumbar vertebral fractures with AF system 　　LI De-chun 　　(Department of Orthopedics，Affiliated Hospital of Qinghai Medical Collage，Xining 810001，China) 　　Abstract: Objective To sum up the treatment experience and effect of thoracolumbar vertebral fractures in43cases.Methods Forty-three cases of thoracolumbar vertebral fracture patients were treated from Apr.1999to Aug.2003.Main injury causes:fall from the high in34cases，traffic accident in6cases and injured by heavy objects in3cas-es.Wounded corpora vertebrae:T 9 1case，T 10 1case，T 11 2cases，T 12 13cases，L 1 15cases，L 2 5cases，L 3 4cases，T 11 and L 1 1case，T 12 and L 1 1case.Results Thirty-seven cases were followed up for half a year-3years.Corpora vertebrae shape recovered from on average preoperative27.45°(17-52°)，as assessed according by Cobbs angle，to postoperative5.3°(0-15°).Height of corpora vertebrae front edge recovered to from on average preoperative56%(15%-77%)to posto-perative89%(62%-100%).According to ASIA classification，13cases showing spinal cord or nerve roots injury symp-toms improved to1-3degree.Conclusion Treatment of thoracolumbar vertebral fractures with AF system is effective.Accurate fixation of corpora vertebrae，selection of exact time of treatment，grafting bone onto damaged corpora vertebrae and recovery of spinal cord or nerve root are very important. 　　Key words:thoracolumbar vertebral fracture;inner-fixation 　　胸腰椎体骨折常致椎体稳定性改变，累及脊髓损伤致瘫痪及大小便功能障碍，若不及时掌握手术时机，改变椎体稳定性及解除