摘要
相邻型两节段胸腰椎骨折患者12例，男9例，女3例，平均28岁。损伤部位T11T123例，T12L16例，L1L23例。其中上病椎损伤轻的7例，下病椎损伤轻的5例。神经功能按Frankel分级：A级4例，B级1例，C级2例，D级2例。E级3例。于连续两个病椎的上下端椎置入预测长度的椎弓根钉，损伤轻的椎体置入长35min的椎弓根钉，形成4椎6钉固定。固定后复查X射线片示后凸角由固定前平均24°（15°～48°）矫正到固定后平均5°（0°～10°），椎体前缘高度由固定前平均38％（20％-65％）恢复到固定后平均95％（85％～100％），随访时间3～48个月，平均24个月，椎体高度无丧失，内固定无松动、断裂。3例Frankel E级的患者术后无神经功能障碍；固定前不全瘫的5例患者中，2例D级、1例C级和1例B级恢复至E级，1例C级恢复至D级；4例Frankel A级的患者，2例无变化，2例恢复至B级。结果提示4椎6钉固定系统可增加固定后维持稳定的能力。
Twelve patients with double-level continuous thoracolumbar fractures consisted of 9 males and 3 females with an average age of 28 years were selected. Of them, 3 cases were involved in T11T12, 6 in T12L1, and 3 in L1L2; 7 cases had slight damage in upper vertebra and 5 had slight damage in lower vertebra. According to Frankel grading, there were 4 cases of grade A, 1 of grade B, 2 of grade C, 2 of grade D, and 3 of grade E. Four suitable pedicle screws were inserted into the upper and lower normal vertebras of the injured segments, respectively, and another 2 pedicle screws of 35 mm long were inserted into the slight damage vertebras in the injured segments. Finally, 4 vertebras were fixed with 6 pedicle screws. Compared with the preoperative average angle of kyphosis deformity, the postoperative X-ray indicated that the angle was improved from 24°（range, 15 o to 48° ） to 5 ° （range, 0° to 10° ）, and the height of anterior border vertebra was improved from 38% （range, 20% to 65%） preoperatively to 95% （range, 85% to 100%） postoperatively. All patients were followed up for 24 months （range 3-48 months）. No vertebral height loss or loosening or breakage of the pedicle screws occurred. Three cases of Frankel grade E did not develop neurologic deterioration postoperation; Of 5 patients with paresis, 2 of grade D, 1 of grade C, and 1 of grade B recovered to grade E, and 1 of grade C recovered to grade D; Of 4 cases of grade A, 2 cases remained unchanged and 2 recovered to grade B. The results of the study indicate that it is feasible to apply 6 pedicle screws to fix 4 vertebras in the treatment of the double-level continuous thoracolumbar fractures.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第22期4295-4298,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
