Yong-Jie Gu, Yong Hu, Ma Wei-Hu, Xu Rong-Ming
Department of Spinal Surgery, Sixth Hospital of Ningbo, Ningbo 315040, Zhejiang, China.
Zhongguo Gu Shang. 2010 Apr;23(4):264-7.
To explore the feasibility and clinical effects of posterior short segmental pedicle screw fixation adding pedicle screw at the fracture level in treatment of thoracolumbar vertebral fractures.
From September 2005 to September 2007, 82 patients (male 50 and female 32, the age from 18 to 63 years, at mean age of 36 years,the courses of disease from 2 hours to 7 days with an average of 2 days) with thoracolumbar fractures were treated with posterior short segmental pedicle screw fixation adding pedicle screw at the fracture level. According to the AO classification, 25 patients were type A1 fracture, 48 were type A2 and 9 were type B2. According to the ASIA neurological function grading system, 9 patients were grade C, 17 were grade D and 56 were grade E. Reduction and posterolateral fusion were achieved through fixation of the fractured vertebra and the adjacent normal vertebrae with the transpedicle screw.
Eighty-two cases were followed up from 12 to 24 months (averaged 18.3 months). All cases achieved bone fusion, without significant lose of the vertebrae body height and implant failure. The anterior body compression and Cobb angle were significantly improved after surgery (P < 0.05). The anterior body compression and Cobb angle did not significantly lose compared with after-surgery ones (P > 0.05). The caudal intervertebral disc height (h/H) were not significantly improved after surgery (P > 0.05). Improvement of one to two grades of neurological function was observed in patients with incomplete neurological injuries.
Posterior short segmental pedicle screw fixation with pedicle screw at the fracture level is a safe and effective therapeutic option to treat thoracolumbar vertebral fractures, which can help to correct the kyphosis and maintain the reduction, and avoid the over-distraction of the contiguous discs.
探讨后路短节段椎弓根螺钉固定并在骨折节段增加椎弓根螺钉治疗胸腰椎骨折的可行性及临床效果。
2005年9月至2007年9月，82例胸腰椎骨折患者（男50例，女32例，年龄18～63岁，平均36岁，病程2小时至7天，平均2天）采用后路短节段椎弓根螺钉固定并在骨折节段增加椎弓根螺钉治疗。按AO分型，A1型骨折25例，A2型48例，B2型9例。按ASIA神经功能分级系统，C级9例，D级17例，E级56例。通过椎弓根螺钉固定骨折椎体及相邻正常椎体实现复位及后外侧融合。
82例患者随访12～24个月（平均18.3个月）。所有病例均获得骨融合，椎体高度无明显丢失，内固定无失败。术后椎体前缘压缩率及Cobb角明显改善（P<0.05）。与术后相比，椎体前缘压缩率及Cobb角无明显丢失（P>0.05）。术后尾椎间隙高度（h/H）无明显改善（P>0.05）。不完全性神经损伤患者神经功能改善1～2级。
后路短节段椎弓根螺钉固定并在骨折节段增加椎弓根螺钉是治疗胸腰椎骨折的一种安全有效的治疗方法，可有助于纠正后凸畸形并维持复位，避免相邻椎间盘过度撑开。
