Speth M J, Oner F C, Kadic M A, de Klerk L W, Verbout A J
Department of Orthopedics, University Hospital, Utrecht, The Netherlands.
Acta Orthop Scand. 1995 Oct;66(5):406-10. doi: 10.3109/17453679508995575.
24 patients with Th12-L1 fractures treated with a Dick internal fixator were analyzed to assess predictors of poor outcome. 4 patients had fixation without bone transplantation, 20 patients had a posterior fusion, and 12 of them had additional transpedicular spongioplasty. There were fractures of the transpedicular screws in 4 and screw migration in 2 cases. The increase in the local kyphosis angle was greater than the increase in the anterior compression angle and this did not correlate with spongioplasty or fusion. Fixation failure was in all cases related to a disproportionate increase in the local kyphosis angle. There was no difference between the patients with transpedicular spongioplasty and posterior fusion and the other patients with respect to results and complications. Bony collapse was not the major cause of failure and consequently there was no measureable contribution of transpedicular spongioplasty. We found that the Dick internal fixator for unstable fractures was associated with a higher complication rate than earlier reported.
对24例采用Dick内固定器治疗的胸12 - 腰1骨折患者进行分析，以评估预后不良的预测因素。4例患者仅行内固定未进行植骨，20例患者接受了后路融合术，其中12例还进行了经椎弓根椎体成形术。4例出现椎弓根螺钉断裂，2例出现螺钉移位。局部后凸角的增加大于前凸压缩角的增加，且这与椎体成形术或融合术无关。所有病例的固定失败均与局部后凸角不成比例增加有关。经椎弓根椎体成形术和后路融合术患者与其他患者在结果和并发症方面无差异。骨塌陷不是失败的主要原因，因此经椎弓根椎体成形术没有可测量的作用。我们发现，Dick内固定器用于治疗不稳定骨折时，其并发症发生率高于早期报道。
