CAJ | 학술논문

目的探讨后路短节段钉棒系统结合伤椎椎弓根钉固定治疗胸腰椎骨折的价值.方法本组患者33例,伤椎部位:T_(11)3例,T_(12)11例,L_110例,L_29例.其中单纯压缩骨折3例,爆裂骨折30例.合并截瘫33例.对单纯压缩骨折行后路短节段钉棒系统结合伤椎椎弓根钉内固定术.对合并截瘫椎管占位明显者固定后行后路椎板减压、椎管开大术,并行小关节突及横突间植骨融合.用Frankel分级评估神经功能.结果术后33例均获随访,平均随访时间14.5个月.术后X线片示椎弓根钉位置好,伤椎复位外形好.随访期内固定无松动或断裂,无慢性腰痛,伤椎高度无丢失.33例合并不全瘫.术前Frankel级:A级1例,B级7例,C级16例,D级9例;术后Frankel分级:A级1例,B级1例,C级5例,D级10例,E级16例.结论对于胸腰椎骨折尤其是胸腰椎爆裂骨折,后路短节段钉棒系统结合伤椎椎弓根钉固定术是一种疗效可靠的内固定方法.
목적 탐토후로단절단정봉계통결합상추추궁근정고정치료흉요추골절적개치.방법본조환자33례,상추부위:T_(11)3례,T_(12)11례,L_110례,L_29례.기중단순압축골절3례,폭렬골절30례.합병절탄33례.대단순압축골절행후로단절단정봉계통결합상추추궁근정내고정술.대합병절탄추관점위명현자고정후행후로추판감압、추관개대술,병행소관절돌급횡돌간식골융합.용Frankel분급평고신경공능.결과 술후33례균획수방,평균수방시간14.5개월.술후X선편시추궁근정위치호,상추복위외형호.수방기내고정무송동혹단렬,무만성요통,상추고도무주실.33례합병불전탄.술전Frankel급:A급1례,B급7례,C급16례,D급9례;술후Frankel분급:A급1례,B급1례,C급5례,D급10례,E급16례.결론 대우흉요추골절우기시흉요추폭렬골절,후로단절단정봉계통결합상추추궁근정고정술시일충료효가고적내고정방법.
Objective To investigate the value of posterior short segment peg-stick system plus pediele screw fixation in treatment of thoracolumbar fractures. Methods There were 38 patients invol-ving fractures at Tn in three patients, at T_(12) in 11, at L_1 in 15 and at L_2 in nine. There were three pa-tients with simple fractures of vertebral compression, 35 with burst fractures, 33 with thoracolumbar frac-tures combined with paraplegia. The patients with simple fracture of vertebral compression were treated by posterior short-segment peg-stick system plus pedicle screw fixation. While the patients with paraplegia and intraspinal occupancy were treated by posterior decompression, vertebral enlargement and bone graft-ing (between zygopophysis and transverse process) after fixation. Results All patients received a fol-low-up for average 14.5 months, which showed accurate position of pedicle screw and fine contour of the injured vertebra after reduction, with no loosening or breakage of fixators, chronic lumbar pain or loss of the height of fractured vertebra. Of all, 33 patients were accompanied by paresis. There was one patient at Grade A, six at Grade B, 16 at Grade C and nine at Grade D before operation. But there was one pa-tient at Grade A, one at Grade B, five at Grade C, 10 at Grade D and 16 at Grade E. Conclusions For thoracolumbar fractures especially vertebral burst fractures, posterior short segment speg-stick system plus pedicle screw fixation is an ideal treatment method, for it has the following advantages: no obvious loss of the height of the vertebra after operation, protection of the intact intervertebral disc under the in-jured vertebra and minor effect on range of motion of the lumbar vertebrae.