东南大学学报（医学版）
東南大學學報（醫學版）
동남대학학보（의학판）
JOURNAL OF SOUTHEAST UNIVERSITY(MEDICAL SCIENCE EDITION)
2014年
2期
173-176
,共4页
胸椎%腰椎%爆裂性骨折%椎弓根器械%骨折固定术
胸椎%腰椎%爆裂性骨摺%椎弓根器械%骨摺固定術
흉추%요추%폭렬성골절%추궁근기계%골절고정술
thoracic%lumbar%burst fracture%transpedicular instrumentation%fracture fixation
目的：探讨对胸腰椎爆裂性骨折应用经骨折椎椎弓应力螺钉加强胸腰椎骨折后路内固定的临床疗效。方法：回顾性研究2007年2月至2009年12月采用骨折椎加用应力螺钉固定22例胸腰椎单一椎体骨折患者的临床资料。其中男15例，女7例，平均年龄38.2岁（21～73岁）。所有患者外伤均不超过1周，骨折椎一侧或双侧椎弓根完整。在施行后路常规撑开和恢复腰椎前凸的同时在骨折椎上应用椎弓根螺钉向垂直于撑开应力方向的腹侧加压，以达到局部的应力平衡。术后随访6～40个月，平均20.3个月。结果：应力螺钉使骨折椎向腹侧移动复位，术后Cobb角及前柱高度恢复较佳。骨折椎加用应力螺钉在前柱撑开的同时可有效控制正常椎间盘高度的撑开。结论：对胸腰椎单一椎体骨折有条件地应用骨折椎椎弓根螺钉可以增强胸腰椎骨折后路短节段内固定系统的牢固性，并有利于矫正后凸畸形和维持矫正效果。
目的：探討對胸腰椎爆裂性骨摺應用經骨摺椎椎弓應力螺釘加彊胸腰椎骨摺後路內固定的臨床療效。方法：迴顧性研究2007年2月至2009年12月採用骨摺椎加用應力螺釘固定22例胸腰椎單一椎體骨摺患者的臨床資料。其中男15例，女7例，平均年齡38.2歲（21～73歲）。所有患者外傷均不超過1週，骨摺椎一側或雙側椎弓根完整。在施行後路常規撐開和恢複腰椎前凸的同時在骨摺椎上應用椎弓根螺釘嚮垂直于撐開應力方嚮的腹側加壓，以達到跼部的應力平衡。術後隨訪6～40箇月，平均20.3箇月。結果：應力螺釘使骨摺椎嚮腹側移動複位，術後Cobb角及前柱高度恢複較佳。骨摺椎加用應力螺釘在前柱撐開的同時可有效控製正常椎間盤高度的撐開。結論：對胸腰椎單一椎體骨摺有條件地應用骨摺椎椎弓根螺釘可以增彊胸腰椎骨摺後路短節段內固定繫統的牢固性，併有利于矯正後凸畸形和維持矯正效果。
목적：탐토대흉요추폭렬성골절응용경골절추추궁응력라정가강흉요추골절후로내고정적림상료효。방법：회고성연구2007년2월지2009년12월채용골절추가용응력라정고정22례흉요추단일추체골절환자적림상자료。기중남15례，녀7례，평균년령38.2세（21～73세）。소유환자외상균불초과1주，골절추일측혹쌍측추궁근완정。재시행후로상규탱개화회복요추전철적동시재골절추상응용추궁근라정향수직우탱개응력방향적복측가압，이체도국부적응력평형。술후수방6～40개월，평균20.3개월。결과：응력라정사골절추향복측이동복위，술후Cobb각급전주고도회복교가。골절추가용응력라정재전주탱개적동시가유효공제정상추간반고도적탱개。결론：대흉요추단일추체골절유조건지응용골절추추궁근라정가이증강흉요추골절후로단절단내고정계통적뢰고성，병유리우교정후철기형화유지교정효과。
Objective:To explore the technique outcome of fixing the ventral stress pedicle screws into the injured vertebrae , in the treatment of thoracolumbar burst fractures .Methods:From February 2007 to December 2009 , 22 single thoracolumbar fractures were studied retrospectively .Among which 15 males and 7 females,aged 38.2 years averagely ( range ,21~73 years ) .All the patients underwent the operation within 1 weeks after fracture .For the injured vertebral bodies ,their pedicles were intact on either unilateral or bilateral side .The pedicle screws in the injured vertebrae were used to achieve eventral press vertical to the distraction for the stress neutralization ,and also with the routine distraction and lordosis restoration , simultaneously .The mean follow-up period was 20.3 months with a range from 6 to 40 months.Results:After operation,the optimal Cobb angle and anterior column restoration were achieved through the ventral reduction from the injured vertebral body , which was resulted from the vertical stress pedicle screw .And the over-distraction of the contiguous discs was also avoided eficiently .Conclusion: It can enhance the stiffness of the posterior short-segment instrumentation in single thoracolumbar fractures through fixing the pedicle screws into injured vertebrae selectively ,which still can help to correct the kyphosis and maintain the reduction .
