摘要目的 探讨脊柱损伤的治疗方法,对手术操作要点及相关问题提出见解.方法 本组205例,均采用后入路,在C臂引导下操作,先打入椎弓根螺钉、椎管减压、体位过伸复位、上连接杆并撑开、将骨块回敲,最后椎旁植骨.结果 术后X线复查,椎体的高度、形态及脊柱生理弯曲基本恢复.随访14～36个月,迟发感染4例,螺钉松动7例,断钉6例(14钉),断棒1例,无继发神经损伤及其它并发症.结论 后路椎弓根螺钉内固定操作容易,能充分扩大椎管达到减压目的 ;结合术中脊柱过伸位复位,有利于恢复伤椎高度,获得更好效果.

abstractsObjective To discuss the surgical treatment of spinal injury, and provide insights on key points and related issues for operations. Methods Two hundred and five cases of spinal fracture were treated through posterior surgical treatment. Under C-arm X-ray monitoring, surgeries had been operated on pedicle screws insertion, vertebral canal decompression, over-extending reduction position, and placed the connecting rod, knocked in the bone graft and finally transplanted the paraspinal bone. Results After operations , the height and morphology of vertebral bodies and spinal physiological curvature were basically recovered analyzed by X ray examination. The follow-up results (in the average of 14 to 36 months) indicated that there were 4 cases of delayed infection, 7 cases of loosen screw, 6 cases of broken screw (14 screws)and 1 case of broken stick, with no secondary nerve injury or other syndromes. Conclusion The vertebral pedicle screw internal fixation manipulated easily, which could sufficiently enlarge vertebral canal in order to decompression. In addition, during the operation, together with over-extending reduction position is beneficial to regain the height of fractured vertebral bodies.