摘要
作者于１９９２年设计经椎弓根外固定器，并进行临床应用，主要特点为螺钉呈锥形，整体关节由“球形垫圈”结构组成。３年治疗不稳定型胸腰椎骨折５０例，切开进钉１３例，闭合经皮进钉３７例。随访时间平均１８个月，病椎Ｃｏｂｂ角、椎前高、最大位移等复位指标术前与术后有显著差异，结果显示器械设计合理、治疗效果满意。作者认为：（１）锥形螺钉可在强度不变条件下减少螺钉在锥弓根内占位，更加安全。（２）“球形垫圈”结构设计既满足器械整体三维空间活动要求，又保证金属体间加压形成“面接触”。（３）外固定器可使“骨－固定器”系统中性层位于骨外，产生骨折界面应力均匀效应。（４）该方法拥有复位固定效果好、创伤小、不需二次手术等优越性。
Anewtranspedicularexternalfixationapparatusthatcharacterizedbyconicalscrewsandintegraljointcomposedofsemi-balwasherweredesignedandappliedclinicalysince1992.Fiftypatientswithunstablefracturesofthethoracolumbarspineweretreatedwiththenewmethodduringthepastthreeyears.Thirteenwerefixedthroughanopenincisionand37werescrewedpercutaneously.Withanaverageof18monthsfolow-up,remarkabledifferenceswereseenintheindexofCobb'san-gle,heightofthevertebraandreductionratebeforeandafteroperation.Theresultsshowedthattheapparatuswasreasonableandefective.Theauthorsconcludedthat:(1)theconicalscrewreducedtheoccupyingspaceinthepediclewithoutweakeningitsintensitymadetheoperationsafer,(2)thesemi-balwashernotonlymetthemovementoftheapparatusinthreedimensionsbutalsomaintainedthecompressiveinterfacesamongthemetals,(3)theapparatusresultedinanevenstressefectonthefrac-tureinterfacesbytransferedtheneutralaxisofthebone-apparatussystemoutofthebone,(4)thepro-cedurebroughtaboutlesstraumaandsatisfactoryreductionandfixationefects.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第10期616-619,共4页
Chinese Journal of Orthopaedics
关键词
经椎弓根
外固定
胸腰椎骨折
TranspedicularexternalfixationUnstablefracturesofthethoracolumbarspine
