中文摘要：

目的讨论移动C型臂cT在A3型胸腰椎爆裂骨折手术中的初步应用及其意义。方法对2012年1月至2014年12月收治的21例单节段AO分型A3型胸腰椎爆裂骨折患者资料进行回顾性研究，男15例，女6例；年龄17～68岁，平均43．6岁；脊髓损伤按照美国脊髓损伤协会（ASIA）分级：A级1例，B级2例，c级12例，D级4例，E级2例。术前进行CT检查，术中使用后路椎弓根螺钉技术对所有患者行骨折撑开复位，再行移动C型臂cT检查骨块复位情况，确定下一步是否实施椎板切开椎管减压、骨折块复位处理。术后再次进行CT检查，并跟踪监控骨折复位和椎管管径复原状况。结果所有患者术后获10—18个月（平均15．5个月）随访。所有患者术后第3天和末次随访时的后凸cobb角、椎体前缘压缩率、椎管占位率、椎体平移率、疼痛视觉模拟评分与术前比较明显减小，差异均有统计学意义（P〈0．05），而以上指标术后第3天与末次随访时比较差异均无统计学意义（P〉0．05）。ASIA脊髓功能恢复良好：B级1例改善为C级，C级4例改善为D级，5例改善为E级，D级3例改善为E级。结论术中移动C型臂cT扫描在A3型胸腰椎爆裂骨折术中对是否进一步行切开椎板减压有一定的指导作用，提高了A3型胸腰椎爆裂骨折治疗的安全性和可靠性，对于手术计划的确定和修改有一定的指导意义。

英文摘要：

Objective To discuss the application of mobile C-arm CT scan in the operations for thora- columbar burst fractures of type A3. Methods From January 2012 to December 2014, 21 patients with sin- gle-segment thoracolumbar burst fracture （AO type A3） were treated. They were 15 males and 6 fcmales, aged from 17 to 68 years （average, 43.6 years）. By the American Spinal Injury Association （ASIA） grading, one was grade A, 2 were grade B, 12 grade C, 4 grade D and 2 grade E. Preoperative CT examination was conducted. Mobile C-arm CT scan was performed to evaluate reduction of the fragments after the fracture was reset by posterior pedicle screwing. Laminotomy for canal decompression or reduction of the fragments would be performed if it was indicated by the results of mobile C-arm CT scan. CT examination was conducted postoperatively to assess the fracture re- duction and recovery of the canal calibre. Results All the patients were followed up for an average of 15.5 months （from l0 to 18 months） . Their cobb angle, vertebral anterior margin compression rate, spinal occupancy rate, vertebral translocation rate and visual analogue score at postoperation and final follow-up were significantly improved compared with their preoperative values （ P 〈 0. 05）, but there were no significant differences between postoperation and final follow-up in all the above indexes （ P 〉 0.05）. Postoperative ASIA grading showed that the spinal function was improved from grade B to grade C in one, from grade C to grade D in 4 cases, from gradeC to grade E in 5 cases, and from grade D to grade E in 3 cases. Conclusion Since intraoperative C-arm CT scan can help decide whether laminectomy for canal decompression is conducted or not in the surgery of thoracolumbar burst fractures, it enhances the surgical safety and reliability.