经椎弓根椎体植骨联合椎弓根钉内固定治疗胸腰椎骨折

目的 探讨经椎弓根椎体植骨联合椎弓根钉内固定治疗胸腰椎骨折的临床疗效.方法 67例胸腰椎骨折患者,均采用经椎弓根椎体植骨联合椎弓根钉内固定手术,术前、术后及随访时X线检查,测量观察椎体高度有无丢失,内固定有无断裂、松动情况发生.结果 手术后患者神经功能损伤均有不同程度的改善,随访12 ～36个月,平均(23.8±9.3)个月.术后1年将内固定取出,均未见内固定松动、断裂等情况,植骨块融合较好,未见骨吸收且脊柱生理弧度维持良好.患者术后及36个月随访时椎体前缘高度、椎体中央高度、椎体后缘高度以及Cobb角均较手术前显著降低,差异有统计学意义(P＜0.05)；而手术后1周与术后36个月随访时各指标的差异无统计学意义(P＞0.05).结论 经椎弓根椎体植骨联合椎弓根钉内固定治疗胸腰椎骨折有良好的临床疗效,可有效地维持伤椎前缘高度.

Transpedicular vertebral body bone graft combined with pedicle screw fixation in the treatment of thoracic and lumbar fractures

Objective To investigate the effect of the transpedical interbody bone grafting plus pedicle screw fixation for the treatment of thoracic and lumbar fractures. Methods 67 thoraeolumbar fracture patients were treated with transpedieular vertebral body bone graft and pedicle screw internal fixation operation, preoperative, postoperative and follow-up uptake X line inspection, measurement and observation of vertebral height has no loss, no fracture, internal fixation loosening occurred. Results Patients with neurological injury after operation were improved to different degree, the follow-up of patients with 12 -36 （23.8 ± 9.3 ） average. After 1 year the patient fixation was not removed, internal fixation loosening,fracture, bone graft fusion better, no bone resorption and spinal physiological curvature to maintain good. Postoperative patients, followed for a mean of 36 months of anterior vertebral body height, height of vertebral body, posterior margin of the vertebral body height and the central angle Cobb operation were decreased significantly, the difference was statistically significant （P 〈 0.05 ） ;and 1 week after operation and postoperative follow-up of an average of 36 months each index showed no significant difference（ P 〉 0.05 ）. Condusion Transpedieular vertebral body bone graft and pedicle screw fixation for the treatment of thoraeolumbar fractures has good clinical curative effect ,which could effectively maintain the vertebral height of the front, with the value of clinical application.