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目的 针对前路减压KANEDA装置内固定方法治疗胸腰段脊柱骨折手术创伤大、失血多.操作复杂和KANEDA装置安装不方便等问题进行技术改进.方法 将KANEDA装置的椎体螺钉与螺棒的穿套式结合方式改为卡锁式结合,采用经第12肋胸膜外－腹膜后入路显露,对手术操作程序和伤椎切除范围进行了改进.结果 38例胸腰段脊柱骨折患者手术均获成功.技术改进后手术中平均失血量880 ML,手术操作时间平均 140分钟,手术切口长度 18~20 CM.随访 9~40个月,平均 24. 3个月.术后无截瘫加重,脊柱序列正常,椎管扩大,无假关节形成和内固定失败,神经功能获1级以上恢复者达97％.结论本技术改进具有切口短、手术创伤较轻、失血少、降低手术操作难度的优点,改型后的KANEDA装置安装简便,固定可靠.“,”Objective To describe the results and advantages of modified Kaneda device and the improved procedure for the treatment of thoraco-lumbar fractures. Methods The insertion lasso connection of Kaneda device was changed into a block connection; an extrapleural and retroperitoneal approach with resec tion of the left twelfth rib were used; thus improved the limit of the extent of vertebral body resection. Results All of the 38 cases had successful surgery; the average operation time was 140 minutes, the average amount of blood loss was 880 ml and the length of incision was 18 - 20 cm. After an average of 24. 3 months fol lowed-up, none of the patients had neurological deterioration; the spinal canals were enlarged, the spine re covered normal curvature and the fusional rate was 100%. No failure of implant happened. Neurological function was improved by at least one grade in 97%. Conclusion The technical improvements have the advantage of less injury, less blood loss and a short incision. The modified Kaneda device fixation not only provided stability but also convenient installation.