经椎弓根内固定系统结合椎体成形术治疗严重胸腰椎骨质疏松性骨折

目的 探讨严重胸腰椎骨质疏松性骨折的手术治疗方法.方法 21例严重胸腰椎骨质疏松性骨折应用经椎弓根内固定系统结合椎体成形术治疗,采用用影像学检查和MacNab脊柱手术疗效评分进行随访.结果 无手术相关并发症出现.平均随访时间24.3月(9～36月).无内固定断裂松动等现象.术前VAS评分6～9分,平均8.4分,术后VAS1～4.5分,平均3.7分.改良MacNab脊柱手术疗效评分,优11人,良6人,一般4人.结论 对于胸腰椎严重骨质疏松性骨折,应用经椎弓根内固定系统结合术中椎体成形术是一个安全有效的治疗方法.

Combined trans-pedical internal fixation and intra-operative vertebroplasty to severe osteoporotic thoracolumbar fractures

Objective To discuss an operative treatment to the severe osteoporotic thoraco-lumbar fracture.Methods 21cases of severe osteoporotic thoraco-lumbar fracture have been treated with trans-pedicular internal fixation comined with vertebroplasty during operation.The patients have been followed up with radiological assecement and.Results There is no operation related complication.Average follow-up time 24.3months(9-36months).There is no hardware failure.Average preoperative VAS 8.4(6-9)while average post-operative VAS 3.7(1-4.5).As for Modified Macnab criteria for characterizing outcome afterspinal surgery,Excellent for 11 cases,Good for 6 cases and fair for 4 cases.Conclusion The combination of transpedicular internal fixation system and intraoperative vertibroplasty is a safe and effective method for the severe osteoporotic thoraco-lumbar fracture.