Objective: To explore and analyze the posterior short-segment pedicle screw fixation for the treatment of thoracolumbar fractures. Methods: From October 2008 to December 2010 30 patients with thoracolumbar fractures were treated with screw fixation of posterior short segment pedicle in our hospital. Preoperative neurological deficit was rated by Frankel, 5 cases were in level A, 3 cases in level B, 6 cases in level C, 5 cases in level D, and 11 cases in level E. Measured variable vertebral wedge index (IVW) and kyphotic Cobb angle by the method of image. Results: 30 patients were followed up for 4-36 months (14 months). The results showed that recovery of neurological function after surgery was rated,2 cases were in level A, 1 cases in level B, 4 cases in level C, 6 cases in level D, and 17 cases in level E. IVW postoperative and fmal follow up was (0.94±0.05), (0.88±0.05), and compared with the preoperative IVW (0.63±0.06), there were significant differences (t=5.23, 4.17, all P＜0.05); postoperative and final follow up Cobb angle to (6.37±0.89), (7.02±0.93),and compared with the preoperative Cobb angle, there were significant differences (t=8.36, 6.52, all P＜0.05). Complete decompression in all cases. the dislocation was good and kyphosis can be corrected. Conclusion: The posterior short segment pedicle screw fixation for the treatment of thoracolumbar fracture has rigid fixation, and the clinical results are satisfactory,which has high rate of spinal fusion.%目的:探讨和分析经后路短节段椎弓根螺钉内固定治疗胸腰椎骨折的疗效.方法:2008年10月～2010年12月,对我院骨科收治的30例胸腰椎骨折患者行后路短节段椎弓根螺钉内固定.术前神经功能损伤按Frankel分级.A级5例,B级3例,C级6例,D级5例,E级11例.影像学测量伤椎楔变指数(ⅣW)和后凸Cobb角.结果:30例均获随访,时间4～36个月,平均14个月,随访结果显示,术后神经功能恢复情况按Frankel分级,A级2例,B级1例,C级4例,D级6例,E级17例.术后及末次随访IVW为(0.94±0.05)、(0.88±0.05),与术前ⅣW(0.63±0.06)比较,差异有统计学意义(t=5.23、4.17,均P＜0.05);术后及末次随访Cobb角(°)为(6.37±0.89),(7.02±0.93),与术前C0bb角(°)比较,差异有统计学意义(t=8.36、6.52,均P＜0.05);所有病例减压彻底,脱位复位良好,后凸畸形得以矫正.结论:在严格掌握手术适应证的情况下,经后路短节段椎弓根螺钉内固定治疗胸腰椎骨折,固定牢固,临床疗效满意,脊柱融合率高.
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