【摘要】 目的探讨后路短节段椎弓根钉固定治疗脊柱胸腰段爆裂性骨折的手术适应证与疗效。方法回顾性分析1999年8月~2008年6月,采用后路短节段椎弓根钉固定治疗脊柱胸腰段爆裂性骨折且资料完整者78例,按Den is分型为A型8例,B型38例,C型12例,D型7例,E型13例。影像学测量伤椎楔变指数(IVW)和后凸Cobb角。结果术后平均随访2.2年,伤椎楔变指数(IVW)术前为0.61,术后为0.92,末次随访为0.89;Cobb角术前为21.10,术后为6.30,末次随访为7.00。术后1年随访时神经功能与术前相比较,差异有统计学意义(P<0.001)。结论应用后路短节段椎弓根钉固定脊柱胸腰段爆裂性骨折具有许多优点,效果满意,但手术适应证有限。更多还原

【Abstract】 Objective To explore the indications and clinical results of thoracolumbar burst fractures treated with short-segment pedicle instrumentation. Methods This study reviewed 78 patients with thoracolumbar burst fractures from August 1999 to June 2008.There were 56 male and 22 female with average age of 36.According to Denis classification,type A fractures were 8,type B were 38,type C were 12,type D were 7 and type E were 13.The variables evaluated by radiographs were index of vertebral wedging at the fracture level(IVW) and regional kyphosis angle(Cobb’s angle). Results The patients were followed up for 1.0~6.0 years(average 2.2 years).The mean value of IVW was 0.61 preoperatively,0.92 postoperatively,and 0.89 at the final follow-up.The mean value of kyphosis angle was 21.10 preoperatively,6.30 postoperatively,and 7.00 at the final follow-up.The one year follow-up group has significantly better neurological outcome when compared with the preoperative group(P<0.001). Conclusion The thoracolumbar burst fractures treated with short-segment pedicle instrumentation has some advantages,and the clinical outcomes are good.However,the indications for short-segment pedicle instrumentation are limited.更多还原