Strømsøe K, Hem E S, Aunan E
Orthopaedic Department, Ullevål Hospital, Oslo, Norway.
Eur Spine J. 1997;6(4):239-44. doi: 10.1007/BF01322445.
Seventy-eight patients were treated with closed reduction and transpedicular fixation for 82 spine fractures. The fractures were localised in the lower third of the spine and were all, according to the Denis classification, considered unstable. Eighteen patients had neurological deficiencies. One patient with a fracture in T11 was completely paraplegic, four patients had a cauda equina syndrome while the rest had radicular symptoms only. Primary reconstruction of the vertebral height and the physiological curves of the spine was satisfactorily obtained. An improvement in the neurological symptoms was observed in all patients with fractures distal to the spinal cord, while the patient with the dislocated fracture of T11 remained completely paraplegic during the follow-up. The complication rate of the transpedicular fixation method used reported by other authors could not be confirmed in our material. Iatrogenic neurological damage was not observed. A partial loss in the correction of the traumatic kyphosis was observed after removal of the implant in 11 patients.
78例患者因82处脊柱骨折接受了闭合复位和经椎弓根固定治疗。骨折位于脊柱下三分之一处，根据Denis分类，均被认为是不稳定的。18例患者存在神经功能缺损。1例T11骨折患者完全截瘫，4例患者出现马尾综合征，其余患者仅有神经根症状。椎体高度和脊柱生理曲度的初次重建效果良好。所有脊髓远端骨折的患者神经症状均有改善，而T11脱位骨折患者在随访期间仍完全截瘫。其他作者报道的经椎弓根固定方法的并发症发生率在我们的研究中未得到证实。未观察到医源性神经损伤。11例患者取出内固定后，创伤性后凸畸形的矫正出现部分丢失。
