【摘要】 目的评估应用非融合手术方式治疗胸腰椎骨折内固定取出后的稳定性,观察在矢状面排列情况和节段运动范围。方法对26例进行了非融合手术治疗的胸腰椎骨折,在术后平均10.2个月时取出内固定,观察超过20个月。影像学上测量固定节段的矢状面排列,骨折椎体高度,屈伸活动范围。结果本组获20～54个月,平均24.4个月的随访。在末次随访时,骨折椎体高度维持良好。骨折时平均矢状面角度为17.5°的后凸,术后平均为2.9°前凸角,在内固定取出前平均为1.8°后凸角,内固定取出后后凸角为2.5°,在最终随访时平均后凸角度为5.9°。矢状面的平均活动范围14.2°。结论非融合手术在获得良好的矢状面排列及恢复固定节段活动上有一定效果,属于治疗胸腰椎骨折一种有效的方式,特别对年轻患者。更多还原

【Abstract】 Objective To evaluate the results of posterior stabilization of thoracolumbar spinal fracture using nonfusion method followed by the removal of metal implants within an appropriate period and investigate the changes in the sagittal alignment and the restoration of segmental motion.Methods Twenty-six patients with thoracolumbar or lumbar spine fractures were managed by this nonfusion method.Implants were removed at a mean 10.2 months after initial fracture fixation,and patients were observed for more than 20 months.Sagittal alignments of metal fixed segments,heights of vertebral bodies,recovered motion ranges in flexion and extension were measured radiologically.Results All patients were followed up for 20~54 months(mean 24.4 months).Heights of fractured bodies were well maintained at final follow-up.Initial mean sagittal angle was17.5° kyphosis,which became 2.9° lordosis after fixation of fractures.This angle was 1.8° kyphosis just before implant removal,2.5° kyphosis just after implant removal,and showed 5.9° kyphosis at final follow-up.Mean segmental motion was 14.2° in the sagittal plane at final follow-up.Conclusion The described nonfusion method appears to be effective in achieving favorable sagittal alignment and regaining motions of fixed segments.And it’s one of the most effective methods for managing thoracolumbar spinal fractures,especially in young active people.更多还原