相邻椎体单节段椎弓根内固定椎间植骨融合治疗胸腰椎骨折

目的研究相邻椎体单节段椎弓根内固定椎间植骨融合治疗轻、中度胸腰椎骨折的可行性和临床疗效。方法回顾性研究32例应用相邻椎体单节段椎弓根内固定技术治疗的胸腰椎骨折的患者，观察复位及植骨融合情况，矫正丢失、腰痛、腰椎活动情况及融合椎体相邻椎间盘退变等并发症发生情况。结果平均随访4．6个月时达到骨性融合，所有患者均得到满意复位，复位率达96％，术后腰痛症状明显缓解，未出现顽固性腰痛、腰椎活动受限等并发症，融合节段相邻椎间盘退变率仅为6％，临床效果明显优于多节段内固定。结论只要适应证选择合适，相邻椎体单节段内固定不但可以达到骨性融合、满意复位、坚强骨性融合，而且较三椎体二节段固定可明显降低顽固性腰痛、腰椎活动受限、相邻椎间盘退变等并发症的发生。

Treatment of thoracolumbar vertebral fracture with adjacent vertebral segment internal fixation and intervertebral body fusion

Objective To study feasibility and clinical effect of nonusegment internal fixation and intervertebral body fusion in treatment of thoracolumbar vertebral fractures. Methods A retrospective study was done on 32 cases with thoracolumbar fractures treated with segment internal fixation and intervertebral body fusion to observe fusion and reduction of bone graft, loss of rectification, low back pain, lumbar vertebral motion and adjacent segment degeneration. Results Follow-up for mean 4. 6 months showed strong bony fusion and satisfactory reduction, with reduction rate of 96%. The degeneration of adjacent intervertebral disc was only 6%, without refractory low back pain or limitation of motion of lumbar vertebrae. Conclusions As long as indication is correctly choosed, monosegnmnt internal fixation and intervertebral body fusion can not only attain strong bony fusion and satisfactory reduction, but also obviously degrade the incidence rate of refractory low back pain and adjacent intervertebral disc degeneration