后路经伤椎椎弓根螺钉内固定治疗胸腰椎爆裂型骨折疗效分析

目的 探讨后路经伤椎椎弓根螺钉内固定治疗胸腰椎爆裂型骨折的临床疗效.方法 选取2007-02~2010-11收治的51例胸腰椎爆裂型骨折患者,其中采用经伤椎椎弓根螺钉内固定治疗33例（6钉组）,跨伤椎双平面椎弓根螺钉内固定治疗18例（4钉组）.所有患者术前、术后、随访均行X线检查,测量伤椎椎体前缘高度值和Cobb＇s角.术后随访3~24个月,平均13.5个月.结果 三椎均顺利完成椎弓根螺钉植入,放置横连杆.螺钉位置及稳定性能良好,无切口感染,无脊髓神经症状加重.伤椎前缘高度和Cobb＇s角恢复满意.术后随访1年,6钉组效果优于4钉组（P=0.002）.结论 后路经伤椎椎弓根螺钉内固定治疗胸腰椎爆裂型骨折可增加骨折固定的稳定性,有效恢复和维持伤椎高度,矫正后凸畸形.

Analysis of therapeutic effect of posterior pedicle screw fixation via injured vertebra in the treatment of thoracolumbar burst fractures

Objective To explore the clinical therapeutic effect of posterior pedicle screw fixation via injured vertebra in the treatment of thoracolumbar burst fractures. Methods From February 2007 to November 2010, 51 pa- tients with thoracolumbar burst fractures were retrospectively studied. Among which 33 were treated with the above method （Group 6 screws）, and the other 18 were treated with traditional two-level fixation method beyond injured ver- tebra （Group 4 screws）. Before and after surgery and at follow up, all patients were evaluated with X-ray for anterior height of injured vertebra and Cobb＇ s angle. Following period were 3 ~ 24 months （mean 13.5 months ）. Results Pedicle screws were successfully implanted and horizontal rods were placed in three vertebra. The position and stabili- ty of screws were in good condition. No incision infection happened and no spinal nerve symptoms got wrose in all pa- tients. Recovery of Cobb＇ s angle and height of the injured vertebra were satisfactory. After 1 year of operation, the effect of Group 6 screws was better that of group 4 screws （P = 0. 002）. Conclusion Posterior pedicle screw fixation via injured vertebra in the treatment of thoracolumbar burst fractures can enhance the stability of fracture fixation ef- fectively, restore and maintain the height of injured vertebra, correct the kyphosis. Its therapeutic effect is better.