ISOLA钉棒系统后路治疗无神经功能障碍的胸腰段脊柱骨折.docVIP

ISOLA钉棒系统后路治疗无神经功能障碍的胸腰段脊柱骨折 作者：周 强，许建中，谭祖键，代 飞 （第三军医大学西南医院骨科，重庆 400038） 摘要: 目的 观察采用ISOLA钉棒系统后路复位固定及植骨融合治疗无神经功能障碍的脊柱胸腰段 骨折的临床疗效。 方法 12例不稳定及畸形较重而无神经功能障碍的脊柱胸腰段骨折患者接受后路ISO- LA钉棒系统复位固定及植骨融合术治疗，取髂骨行椎板及横突间植骨。通过影像学检查脊柱畸形角（Cobb s角）的纠正、内固定的位置及骨愈合情况。 结果 手术7天后均逐渐恢复穿衣、起卧床、步行、大小便及洗 漱等生活自理能力，术后1个月逐渐恢复非弯腰的轻体力工作。所有病例骨折复位良好，后凸及侧凸畸形 均获得满意的矫正，缩小的椎管管径完全得到恢复。随访11例，均无畸形矫正丢失和伤椎及椎间高度下 降，且未出现钉棒松动及断裂。 结论 ISOLA钉棒系统后路复位胸腰椎骨折的性能良好，并具有稳定固定强 度，对无神经功能障碍的脊柱胸腰段骨折复位固定融合治疗具有良好的临床疗效。 关键词: 胸椎; 腰椎; 脊柱骨折; 内固定器; 脊柱融合术 Treatment of thoracolumbar fractures without spinal cord injury by posterior ISOLA system fixation ZHOU Qiang，XU Jian-zhong，TAN Zu-jian，et al. （Department of Orthopaedics，Southwest Hospital，Third Military Medical University，Chongqing 400038，China） Abstract: Objective To investigate the clinical efficacy of the treatment of thoracolumbar fractures without spinal cord injury by posterior ISOLA system reduction and fixation and bone grafting. Methods Twelve cases of instable thoracolumbar fractures with severe malformation and without spinal cord injury were surgically managed by posterior ISOLA system reduction and fixation and bone grafting. The autologous bone graft from ilium was implanted onto the vertebral lamina and transverse processus. The operative notes，radiographs，CT scan and MRI scan and fol- low-up records were reviewed. Results All of 12 cases had successful surgery. Eleven patients were followed up for 6～18 months. All of the patients gradually restored the self-dependence of living at the 7th day after the opera- tion and part or full day work one month after the operation. Postoperative X-ray and MRI showed the fractures were perfectly reduced and the spinal canal stenosis were completely relieved in all cases. The spinal malformations were finely corrected without loss of the correction and implant failure in following up. Conclusion The thoracolumbar fractures without spinal cord inj