摘要
目的探讨应用椎弓根螺钉内固定治疗不稳定中上胸椎骨折的临床效果。方法对自2001年3月起收治的17例经椎弓根螺钉内固定治疗的不稳定中上胸椎骨折患者进行回顾性分析,骨折部位:T31例,T42例,T52例,T64例,T76例,T82例。其中压缩性骨折9例,骨折脱位5例,爆裂型骨折3例。本组均行后路椎弓根螺钉内固定及后外侧植骨融合,其中江苏武进通用型脊柱内固定系统(GSS)固定11例,AO通用脊柱内固定系统(USS)固定6例。结果本组17例均获随访,随访时间为10～38个月,平均21.1个月,伤椎前缘高度由术前平均40%恢复至术后91%,螺钉位置不良4枚,术后无神经系统症状加重,随访时无内固定松动及断裂,伤椎高度及脊柱生理弧度无丢失。结论胸椎椎弓根螺钉内固定是治疗不稳定中上胸椎骨折的一种有效方法,中上胸椎椎弓根螺钉固定有一定风险,但只要熟悉其解剖特点,正确选择螺钉直径及进针点、角度和深度,胸椎椎弓根螺钉可安全地置入椎弓根。
Objective To study the clinical effect of pedicle screw fixation in treatment of unstable upper and middle thoracic vertebrae fractures. Methods A retrospective study was performed on 17 cases of unstable upper and middle thoracic vertebrae fractures treated with vertebral pedicle screw system （ GSS 全称 in 11 cases and USS 全称 in six ） fixation, posterolateral bone grafting and fusion from March 2001 on. There were one case of T3 , two T , two T5 , four T6 , six T7 and two T8. Of all, nine cases were with compression fractures, five with fra, ure-dislocation and three with burst fractures. Resuits All cases were followed up for 10-38 months （average 21. 1 months）. During the follow up, the anterior vertebral body height was restored from preoperative 40% to postoperative 91%. Except for four screw malpositions, there was no postoperative neurologic deterioration, screw loose or breakage of the internal fixation, or loss of the normal spine curve and the spinal height of the injured vertebra. Conclusions Pedicle screw fixation is an effective way for treating unstable upper and middle thoracic vertebrae fractures. Correct placement depend on a comprehensive familiarity of pedicle anatomy, appropriate pedicle diameter and entry point and depth can avoid potential risks in placing pedicle screws into the upper and middle thorax.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2005年第9期687-689,共3页
Chinese Journal of Trauma
