一种新型修复胸腰椎骨折体外撑开复位器的设计与研发

摘要

背景:对于无神经根症状的老年骨质疏松性胸腰椎爆裂骨折在传统术式与保守治疗之间难以抉择,各有利弊.如何在治疗中取长避短呢?微创理念的介入搭建了新的平台,提供了一种新的思路及治疗手段.目的:设计并研发一种新型胸腰椎体外撑开复位器,应用于修复老年骨质疏松性爆裂骨折.方法:作者自行设计并研发了一种新型胸腰椎体外撑开复位器,包括固定支架、导针和两根中空螺钉,其特征在于还包括撑开器、加压器和扳手.依据"筋骨并重"理论并结合实际解剖情况,运用经皮韧带整复技术,恢复椎管内占位的骨块.结果与结论:作者设计的胸腰椎体外撑开器结合韧带整复技术既能适用于老年骨质疏松性爆裂骨折,亦能应用于老年骨质疏松性压缩骨折,经皮微创操作,通过多角度撑开,既能恢复前、中柱高度,又能纠正Cobb's角.同时可以配合伤椎经皮椎体成形术的治疗,伤椎内注入骨水泥,根据患者经济情况也可配合使用经皮球囊扩张椎体后凸成形治疗,为老年人提供一种低廉、痛苦小、创伤小的修复方式.%BACKGROUND:For the elderly osteoporotic thoracolumbar burst fractures without nerve root symptoms,it is difficult to choose between traditional surgical and conservative treatment,because they have their advantages and disadvantages.How to select their advantages and to discard their disadvantages? Concept of minimal invasion builds a new platform and provides a new way of thinking and therapeutic tool.OBJECTIVE:To design and develop a new thoracolumbar distraction reduction devicein vitro in the repair of elderly osteoporotic burst fractures.METHODS:We designed and developed a new type of thoracic and lumbar spinein vitrodistraction reduction device,including bracket,guide pin and two holow screws.Its characteristic is that it also contained distractor,pressurizer and wrench.In accordance with the theory of "muscles as important as bones" and actual anatomical condition,bone fragment in the spine canal was restored using percutaneous ligament reconstructive technique.RESULTS AND CONCLUSION:This thoracic and lumbar spinein vitro distraction reduction device combined with ligament reconstructive technique can be used in elderly osteoporotic burst fractures and elderly osteoporotic compression fractures.It is percutaneous minimaly invasive operation,can restore the height of anterior and central cylinders and correct Cobb's angle through multi angle distraction.Simultaneously,percutaneousvertebroplasty can be utilized.Bone cement was infused in the injured vertebra.According to patients' economic situation,percutaneous baloon kyphoplasty can be employed.These can provide an inexpensive,less-pain,less-invasive way to repair.