摘要
目的 研制新型胸腰椎后路椎弓根钉板系统 ,观察其临床应用效果。方法 该系统采用医用钛合金材料 (TC4)制成 ,包括长条形钢板及椎弓根固定螺栓。自 1999年 12月至 2 0 0 0年 7月间 ,我院骨科应用该系统治疗胸腰段及腰椎伤患者 6 3例 ,其中骨折 /脱位 33例 ,腰椎椎弓峡部裂并滑脱 16例 ,腰椎椎弓峡部裂并椎间盘突出症 6例 ,退变性腰椎不稳 4例 ,强直性脊柱炎伴脊柱后凸畸形2例 ,脊柱结核 2例。结果 33例骨折 /脱位患者中 ,术后复位固定均满意 ,椎体高度恢复。术后 1个月复查 ,除 6例术前FrankelA级患者无恢复外 ,其他有神经损害者均有 1～ 3级的恢复。腰椎滑脱、双侧峡部裂合并椎间盘突出症、退变性腰椎不稳 2 6例中 ,术后神经根性症状均消失 ,其中Ⅰ度滑脱 7例完全复位 ,Ⅱ度滑脱 9例有 7例完全复位 ,2例残留Ⅰ度滑脱。 6 3例患者中有 40例获得≥ 5个月的门诊随访 ,无钢板断裂 ,螺钉松动、断裂、脱落等并发症。结论 该新型胸腰椎后路内固定系统具有良好的生物稳定性 ,复位固定效果满意 ,操作简便 。
Objective To develop a posterior STBTM thoracolumbar transpedicular screw plate system and to apply it clinically. Methods A posterior STBTM thoracolumbar transpedicular screw plate system was developed with titanium alloy (TC4, Ti64A14V) and was used, from December 1999 to July 2000, to treat 63 cases with thoracolumbar or lumbar injuries or diseases, including thoracolumbar fracture/dislocation (33 cases), lumbar spondylosis and spondylolisthesis (16 cases), lumbar spondylosis and disk protrusion (6 cases), degenerative lumbar instability (4 cases), kyphosis due to ankylosing spondylitis (2 cases), and tuberculosis of spine (2 cases). Results The 33 cases with thoracolumbar fracture/dislocation showed perfect reduction and fixation after the operation. The height of injured vertebral bodies returned to normal. One month later, all patients with neurological deficits, except the 6 cases with neurological deficits of Frankel grade A, showed improvement by 1～3 Frankel grades. The radicular symptoms in the 26 patients with lumbar spondylolisthesis, lumbar spondylosis and disk protrusion, and degenerative lumbar instability disappeared after operation. Among those cases, complete reduction was achieved in the 7 cases with grade I spondylolisthesis and 7 out of the 9 cases with grade II spondylolisthesis, and incomplete reduction (grade I) was seen in the remaining 2 cases with grade II spondylolisthesis. Forty cases were followed up for 5 months or over in out patient department, no complication was found. Conclusion The posterior STBTM thoracolumbar transpedicular screw plate system has the advantages of biological stability, excellent reduction capacity, easiness of operation, and positive clinical effectiveness.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2001年第13期794-797,共4页
National Medical Journal of China
