摘要
目的:探讨髂骨钉联合椎弓根螺钉固定治疗腰骶段骨折脱位的可行性、手术方法及疗效。方法:2003年3月～2009年2月对11例腰骶段骨折脱位行髂骨钉联合椎弓根螺钉固定。AO分型均为C型损伤;术前ASIA神经功能分级中,B级3例,C级6例,D级2例。手术采用后正中入路,首先暴露伤椎后方结构及双侧髂后上棘,在上位一正常腰椎置入椎弓根螺钉,然后选髂后上棘为入点,平行于髂嵴置入髂骨钉,再行椎板切除椎管减压,预弯棒置棒,行撑开或加压使骨折脱位复位,最后行后外侧植骨。通过比较术前、术后和随访的X线片,观察神经功能恢复情况。结果:11例获随访,平均16个月。术后X线片显示骨折脱位复位满意,骨折6个月时均愈合,植骨全部融合;随访期间无内固定物松动断裂。所有患者在术后12个月时ASIA神经功能分级均有1级或1级以上的恢复。结论:髂骨钉联合椎弓根螺钉固定不仅操作方便,而且复位固定可靠,临床疗效满意。
Objective： To study the feasibility, surgical methods and efficacy of fixation by iliac screws combined with pedicle screws to treat the lumbosacral fracture dislocation. Methods： From March 2003 to February 2009, 11 patients with the lumbosacral fracture dislocation were treated by iliac screws combined with pedicle screws. AO classification, all were C type injury; preoperative ASIA neurological grade, B grade in 3 cases, C grade in 6 cases, D grade in 2 cases. Through posterior midline approach, first revealed the rear structure of vertebral injury and the bilateral posterior vertebral posterior superior iliac spine, next in a normal upper lumbar placed pedicle screw, and then selected posterior superior ili- ac spine for entry points, parallel to the iliac crest placed the iliac nail, then spinal decompression lamine, pre set rod bending rod, distraction or pressure reduction, the last posterolateral bone graft. By comparing the X ray film of preopera tive and postoperative and follow up to observe the recovery of neurological function. Results： 11 patients were followed an average of 16 months. After surgery X ray film showed satisfactory fracture reduction, the fracture healed at 6 months with all bone graft fusion. There were not implant loosening and fracture during follow up. All patients have a grade in crease or more in ASIA neurological functionl2 months after surgery. Conclusion： It is not only easy to operate, and reli able fixation and clinical results are satisfactory that iliac screws combined with pedicle screws to treat the lumbosacral fracture dislocation.
出处
《中国医药导报》
CAS
2011年第14期44-46,共3页
China Medical Herald
关键词
髂骨钉
椎弓根螺钉
腰骶段骨折脱位
Iliac screw
Pedicle screw
Lumbosacral fracture dislocation
