Mozes G C, Kollender Y, Sasson A A
Department of Orthopaedic Surgery, Soroka Medical Center, University of Ben Gurion, Beer-Sheva, Israel.
Bull Hosp Jt Dis. 1993 Spring;53(1):37-44.
A total of 41 consecutive cases of unstable lumbar and lower thoracic spine fractures or fracture dislocations were treated by the authors at the Soroka Medical Center, Beer-Sheva, Israel between 1988 and 1992, using the Dick Internal Fixator, for reduction of the deformity and fixation. Twenty-nine of the 41 cases, 19 males and 10 females with an average age was 30.5 years, had a mean postoperative follow-up of 24 months Their injuries, 44 fractured vertebrae, were due to road traffic accident in 11 instances, falls from a height in 11 (of whom 4 were suicide attempts), work accidents in 6, and gunshot wound in 1. Among the vertebral injuries, 3 patients sustained a two-column injury and 26 a three-column injury, according to the Denis classification. Reduction of the kyphotic deformity was achieved, obtaining the proper height of the injured vertebra or reduction of the fracture-dislocation, and assuring a proper fixation, using a bilateral transpedicular screw-rod fixation system. Neurological improvement occurred in 9 cases of the 18 who had neurological deficit at admission. According to Frankel's criteria, these patients had an average of 1.125 Frankel's grade improvement; three of these patients recovered completely. There were no operative or postoperative deaths. Major complications included one case of major postoperative gastrointestinal bleeding, one case of pulmonary emboli, and two cases of deep wound infections. This study recommends the use of the Dick Internal Fixator for the correction of major spinal deformities due to its greater structural rigidity and greater availability of bone surfaces for fusion.
1988年至1992年间，作者在以色列贝尔谢巴的索罗卡医疗中心，使用迪克内固定器对41例连续性不稳定腰椎和下胸椎骨折或骨折脱位患者进行了治疗，以矫正畸形并进行固定。41例患者中，29例（19例男性，10例女性，平均年龄30.5岁）术后平均随访24个月。他们的损伤包括44个椎体骨折，原因分别为：11例道路交通伤，11例高处坠落伤（其中4例为自杀未遂），6例工伤事故，1例枪伤。根据Denis分类，椎体损伤中，3例为两柱损伤，26例为三柱损伤。采用双侧椎弓根螺钉-棒固定系统，实现了后凸畸形的矫正，恢复了受伤椎体的正常高度或矫正了骨折脱位，并确保了牢固的固定。入院时存在神经功能缺损的18例患者中，9例神经功能得到改善。根据Frankel标准，这些患者平均Frankel分级提高了1.125级；其中3例患者完全恢复。无手术或术后死亡病例。主要并发症包括1例术后严重胃肠道出血、1例肺栓塞和2例深部伤口感染。本研究推荐使用迪克内固定器矫正严重脊柱畸形，因其具有更高的结构刚度和更多用于融合的骨表面。
