【摘要】 目的　探讨AF椎弓根内固定系统治疗胸腰椎爆裂骨折的疗效 .方法　 4 2例胸腰椎爆裂骨折的病人采用个性化复位及AF内固定系统固定 ,并根据X线和CT对骨折畸形、神经功能的恢复情况、背痛以及并发症等情况进行观察 ,对治疗结果进行评估 .结果　脊柱后凸角度、脊柱中柱突入椎管内程度、椎体前缘高度由术前 15 .9% ,2 9.3%和 5 1.4 %恢复至术后 5 .2 % ,8.5 %和 92 .6 % ,2 2例神经功能合并不全脊髓损伤者获得Ⅰ～Ⅲ级的恢复 ;5例病人术后出现中度腰背痛 ;4例病人并发复位不良 ;2例断钉 .结论　AF椎弓根由固定系统对胸腰椎爆裂骨折复位确切 ,椎管间接减压效果佳 ,但对D型骨折 ,尤其是合并后纵韧带断裂的病例间接减压效果不佳更多还原

【Abstract】 Objective To assess the effect of AF pedicle screw system in treatment of the thoracolumbar burst fractures.Methods 42 patients who suffered from acute burst fractures of thoracolumbar spine were treated surgically with characterizated reduction and fixation of AF pedicle screws,and their effect were evaluated according to X ray and CT findings of the fracture defonities, neurologic function improvement, backpain and complications.Results Kyphotic deformties were corrected from15.9°preoperatively to 5.2°postoperatively; The degree of bone fragment intruding into the spinal canal were decreased from 29.3% preoperatively to 5.2% postoperatively; Height of compressed vertebral bodies were restored from 51.4% preoperatively to 92.6% postoperatively. Neurologic function of 22 patients who suffered from incomplete paralysis were improved from Ⅰ to Ⅲ Frankle grade. 5 cases felt medium backpain, bad reduction found in 4 cases and breakage of pedicle screws found in 2 cases.Conclusion Internal fixation with AF pedicle screws proved surely effective and reasonable in management of thoracolumbar burst fractures, but indrect decompression was not particularly good to the fractures of type Denis D, especially complicated by severance of the posterior longitudinal ligament.更多还原