摘要目的 对终板法伤椎植钉单节段内固定治疗胸腰椎单椎体骨折的生物力学及临床效果进行评价.方法 取猪的24个新鲜胸腰椎椎体标本,48个椎弓根,随机分成4组,分别应用"平行法"及3种不同"终板法"植钉,比较4种植钉法的抗拔出强度.同时回顾分析2003年3月至2006年6月应用该技术治疗的49例胸腰椎骨折患者手术前后伤椎的前后缘高度、后凸Cobb角、椎管内径及矫正丢失、顽固性腰痛、腰椎活动受限等并发症发生情况.结果 "终板法"椎弓根螺钉抗拔出强度明显高于"平行法","伤椎植钉"与正常椎体的"终板法"植钉具有相同的抗拔出强度.49例患者术后均得到良好复位及骨性融合,无内固定失败,无明显矫正角度丢失以及顽固性腰痛、腰椎活动受限等并发症.结论 终板法伤椎植钉单节段内固定能提供足够的抗拔出强度,临床疗效满意.

abstractsObjective To evaluate the biomechanical and clinical effect of the treatment of thoracolumbar fracture with monosegmental pedicle instrumention in the fracture vertebrae by endplant method. Methods Twenty-four porcine thoracolumbal spinal model, divided into four groups randomly, compared the stability of these four groups through pull-out testing. Retrospective study of 49 patients with thoracolumbar fracture who were treatmented with this technique, to observe the fusion of bone graft, the height of the anterior and posterior range, the angle of kyphosis and the volume of spinal canal, the loss of rectification, low back pain , and the limitation of activity of lumbar. Results The endplant method group is more stability than the parallel method group, and the pedicle screw in the fracture vertebrae can get enough stability. After operation all 49 cases achieved satisfactory reduction , strong bone fusion, no reduction loss, no refractoriness low back pain, limitation of motion of lumbar et al. Conclusion Monosegmental pedicle instrumention by endplant method in the fracture vertebrae for thoracolumbar fracture can get enough extraction stability, and get satisfied clinical effect.