经伤椎椎弓根椎体成形术在胸腰椎压缩性骨折中的应用

目的探讨经伤椎椎弓根椎体成形术治疗胸腰椎压缩性骨折的临床效果。方法采用经伤椎椎弓根椎体成形术对2008年1月—2010年10月本院收治的17例胸腰椎压缩性骨折患者进行手术治疗。评估手术前后以及随访期间的椎体后凸角度、前缘高度,观察骨折愈合情况。结果 17例患者获随访7～39个月,平均18个月。后凸畸形由术前的（31.0±1.6）°纠正至术后的（6.0±1.7）（°t=7.457,P=0.050）,随访期丢失角度为（0.2±0.4）°。术前伤椎前缘高度（16.0±0.8）mm,术后达到（21.0±0.7）mm,差异有统计学意义（t=18.439,P=0.000）;随访期间则无明显变化（t=1.852,P=0.083）。术后融合时间3～6个月,平均3.5个月。术前背痛17例,术后消失12例,减轻5例。术前双股部刺痛3例,术后消失2例,减轻1例。随访期间无内植物失败或骨水泥渗漏发生。结论经伤椎椎弓根椎体成形术有助于纠正胸腰椎压缩性骨折患者椎体后凸畸形,恢复伤椎前缘高度,缓解术前神经刺激症状,疗效较为满意。

Application of transpedicular vertebroplasty in the treatment of thoracolumbar compression fractures

Objective To evaluate the effects of transpedicular vertebroplaty in the treatment of thoracolumbar compression fractures. Methods From Jan. 2008 to Oct. 2010, 17 patients with traumatic thoracolumbar compression fractures underwent transpedicular vertebroplasty in our hospital. The preoperative, postoperative, and follow-up plain x-ray films were evaluated. Radiographic analysis included measurements of kyphotic angle, anterior vertebral body height, and evidence of bone fusion. Results The mean follow-up period was 18 months （range 7-39 months）. Kyphotic deformity was corrected from （31.0 ± 1.6）° at preoperation to （6.0 ± 1.7）° at postoepration（t = 7.457,P = 0.050）, the mean loss angle of kyphosis correction at follow-up was （0.2 ± 0.4）°. The anterior vertebral body height was improved from （16.0 ± 0.8） mm at preoperation to （21.0 ± 0.7） mm at postoperation（t = 18.439,P = 0.000）, no obvious change occured at follow-up（t = 1.852,P = 0.083）. There were 17 cases with back pain, while obtained recovery in 12 cases and relief in 5 cases after surgery. Preoperative sharp pain on double strands occurred in 3 cases while good recovery in 2 cases and relief in 1 case. All patients had no implant failure or cement leakage. Conclusions For thoracolumbar compression fractures, transpedicular vertebroplasty may be helpful for correcting kyphotic deformity, restoring anterior vertebral body height, improving preoperative symptom of nerve stimulation, and therefore obtaining satisfactory clinical outcome.