后路椎弓根钉系统固定加经椎弓根人工骨植入术治疗胸腰椎爆裂性骨折

目的]评价后路椎弓根钉系统固定加经椎弓根植入人工骨治疗胸腰椎爆裂性骨折的临床疗效,探讨其适应证的选择。方法]采用爆裂性骨折的Denis分类,对26例无瘫痪胸腰椎爆裂性骨折患者实施后路椎弓根钉系统撑开复位内固定后经椎弓根植入人工骨(NovaBone又名固骼生)进行治疗。26例患者均为单一节段椎体骨折,椎体的破坏程度采用McCormack的LSC评分。结果]26例病人术后疼痛均明显缓解(VAS评分改善),椎体高度和形态得到明显恢复(Cobb角平均改善11.5°)。经术后平均20.5个月随访,疼痛均消失,骨折均达到满意复位并愈合,无Cobb角加大,未发现明显并发症。结论]后路椎弓根钉系统固定加经椎弓根植骨术能及时增加椎体的骨容量和脊柱前柱的抗压稳定性,使患者早期活动,减少内固定因应力过大造成的断钉、断杆、椎体再压缩等并发症,是一种治疗胸腰椎爆裂性骨折的有效方法。此方法适用于椎体压缩程度大、或合并有骨质疏松的胸腰椎爆裂性骨折患者。

Application of combining pedicle srew fixation with bone graft of vertebral body via pedicle for treatment of thoracolumbar burst fractures

Objective] To investigate the method and effect for treatment of thoracolumbar vertebral burst fractures by the method of pedicle screw fixator with bone graft of vertebral body via pedicle,and consider its indications.Method]At the standard of Denis,twenty-six cases of thoracolumbar vertebral burst fractures were treated by combining pedicle srew fixation and bone graft of vertebral body via pedicle.All were single vertebral fractures,and range of vertebral destroy was ruled by LSC scale of McCormack.Result]In a total of 26 cases,all patients' pain distinctly relieved,and all fractures reached osteal concrescence and Cobb angle improved.After an average of 21 months' follow up,no complication occured in all cases.Conclusion]Application of combining pedicle srew fixation and bone graft of vertebral body via pedicle can reconstruct vertbral shape and height,and increase the stability of the spine,and reduce the possibility of breaking of nail and other complications.It can enable the patients to move around as early as possible.Meanwhile it is a good minimal invasive method in treatment of osteoprotic vertebbral fractures.