摘要
目的 探讨和评估Z plate前路钢板治疗胸腰椎骨折的价值和作用及手术适应证。 方法 对 4 5例胸腰椎骨折病例行一期前路减压、植骨融合、Z plate内固定。结果 3例失访 ,4 2例进行 3～34个月的随访 ;按Frankel分级 2 3例术前有神经症状者完全恢复正常 ,13例有部分恢复 ,4例无任何恢复 ,无一例神经功能加重 ,术前与随访时Frankel分级差异有显著性 (P <0 0 5 )。脊柱矢状位和冠状位的Cobb角术后与术前比较差异均有显著性 (P <0 0 1)。并发症 :1例气胸 ,3例肺部感染 ,2例术前无侧凸畸形患者术后出现 4 5°和 7 8°的侧凸畸形 ,所有病例均未出现内固定的松动、断裂。结论 Z plate钢板是一种疗效确实的胸腰椎前路固定系统 ,其稳定性可靠 ,操作简单、安全、并发症少 ;
Objective To study and evaluate clinical efficacy of Z plate and indications for the anterior approach fixation of thoracolumbar fracture. Methods 45 cases of thoracolumbar fracture underwent a one stage direct anterolateral decompression with sagittal reduction and corpectomy, antologous bone grafting reconstruction and Z plate fixation procedure. Results 3 cases were lost to follow up, and 42 cases were followed up for an average of 10 9 months (range: 3 to 34 months). According to Frankel classification of neurologic deficit, 23 of 40 cases with neurologic deficits recovered completely;13 of 40 cases obtained a good or excellent functional outcome;4 of 40 cases didn't recover. No patient had neurologic deterioration after surgery. Preoperative and follow-up Frankel scores had a significant difference( P <0 05). In spinal sagittal plane and coronal plane, preoperative and posterior Cobb's angle had a significant difference( P <0 01). Complications included pneumothorax in 1 patient, pulmonary infection in 3 patients, coronal plane deformity in 2 patients (4 5 degree and 7 8 degree). Neither breakage of instruments nor loosening of connections was found. Conclusion Z plate system is an effective ideal thoracolumbar anterior internal fixation system. It has the advantages of reliable easy manipulation,safety and less complications. It is important to select the proper indication for the anterior approach in thoracolumbar fracture.
出处
《临床骨科杂志》
2003年第4期303-306,共4页
Journal of Clinical Orthopaedics
关键词
内固定器
胸腰椎
脊柱骨折
脊髓损伤
internal fixatiors
thoracolumbar spine
spinal fractures
spinal cord injuries
