经伤椎椎弓根植骨置钉后路复位内固定治疗胸腰椎骨折临床分析

目的：分析经伤椎椎弓根植骨置钉后路复位内固定治疗胸腰椎骨折的临床效果。方法将80例胸腰椎骨折患者根据随机数字表法分为研究组40例和对照组40例，研究组采经伤椎椎弓根植骨置钉后路复位内固定治疗，对照组采取常规跨伤椎的后路复位内固定术。比较两组手术时间、出血情况及临床疗效，分析经伤椎椎弓根植骨置钉后路复位内固定术治疗胸腰椎骨折的临床效果。结果研究组手术时间为（110．0±14．9）min，长于对照组的（91．0±13．7）min（t＝5．93，P＜0．05）；研究组、对照组术中出血量分别为（270．0±34．4）mL、（258．0±42．5）mL，两组差异无统计学意义（t＝1．38，P＞0．05）；研究组末次随访时术后伤椎前缘高度、Cobb角、VAS评分分别为（91．3±1．7）％、（11．2±1．9）＆#176;、（2．5±0．2）分，均优于对照组的（86．6±2．3）％、（14．5±1．1）＆#176;、（3．5±0．9）分（t＝5．25、3．24、6．17，均P＜0．05）。结论经伤椎椎弓根植骨置钉后路复位内固定术治疗胸腰椎骨折能够有效矫正脊柱后凸畸形、重建椎体高度、增加椎体的稳定性，减少和避免术后椎体高度丢失、内固定物松动及断裂等并发症的发生。

Clinical analysis of vertebral pedicle bone graft after posterior pedicle screw fixation in the treatment of tho-racolumbar fracture

Objective To analyze the clinical effects of vertebral pedicle bone graft after posterior pedicle screw fixation in the treatment of thoracolumbar fractures .Methods 80 cases with thoracolumbar fractures were ran-domly divided into the study group （ 40 cases ） and control group （ 40 cases ） .The study group used simple pedicle screw fixation , posterior reduction , and the control group adopted conventional inter vertebral internal fixation .The operation time,hemorrhage were compared between the two groups .The clinical effects of posterior transpedicular in-strumentation of bone graft and vertebral pedicle screw in fractured vertebra in the treatment of thoracolumbar fractures were analyzed.Results The operation time of study group was （110.0 ±14.9）min,which was longer than that of the control group[（91.0 ±13.7）min]（t=5.93,P〈0.05）.The intraoperative blood loss of the study group and the control group were （270.0 ±34.4） mL,（258.0 ±42.5） mL,respectively,with no significant difference between the two groups（t=1.38,P〉0.05）.At the end of the follow-up after the operation,the anterior vertebral height,Cobbangle,VAS scores in the study group were （91.3 ±1.7）%,（11.2 ±1.9）＆#176;,（2.5 ±0.2）%,which were better than （86.6 ±2.3）%,（14.5 ±1.1）＆#176;,（3.5 ±0.9）% in the control group （t =5.25,3.24,6.17,all P 〈0.05）. Conclusion Vertebral pedicle bone graft posterior pedicle screw fixation in the treatment of thoracolumbar fractures can effectively correct the kyphosis ,reconstruct vertebral height ,increase the stability of the vertebral body ,reduce and prevent postoperative vertebral height lost ,loosening and fracture fixation complications .