硫酸钙人工骨灌注椎体成形结合椎弓根钉固定治疗胸腰椎骨折

为探讨硫酸钙人工骨灌注椎体成形结合椎弓根钉固定治疗胸腰椎骨折的临床疗效。采用短节段椎弓根钉系统对胸腰椎骨折复位内固定后随机分为2组，治疗组36例（A组）经一侧椎弓根伤椎内灌注硫酸钙人工骨行椎体成形术，对照组40例（B组）不行椎体成形术。分剐于于术前、术后、随访6～16个月（平均12个月）3个时段观测伤椎矢状位指数、椎体前后缘高度压缩率、脊髓神经损伤恢复情况、腰背疼痛改善情况及内固定并发症等。结果，脊柱矢状位指数和椎体前、后缘高度压缩率术前后比较，两组均无统计学差异；脊柱矢状位指数、椎体前缘高度压缩率比较，两组间有显著性差异（P〈0．01）；椎后缘高度压缩率比较，两组间无差异（P〉0．05）；腰背疼痛改善情况两组比较，有统计学差异（P〈0．01）；脊髓神经损伤恢复情况比较，两组无差异（P〉0．05）；A组无内固定并发症，B组内固定断裂者占10％。表明硫酸钙人工骨灌注椎体成形结合椎弓根钉固定治疗胸腰椎骨折，能减少后突畸形矫正度丢失，在降低内固定并发症及改善腰背疼痛症状方面效果优于对照组，是治疗胸腰椎骨折的安全有效方法。

EFFCET ON CALCIUM PHOSPHATES ARTIFICIAL BONE COMBINED WITH TRANSPEDICULAR FIXATION TO TREAT THORACOLUMBAR FRACTURE

In order to study the effect of calcium phosphates artificial bone (CPA) for vertebral plasty with transpedicular fixation(TSC) on thoracolumbar fracture(TCF), 76 TCF patients were divided into 2 groups: group A (36 patients, treated by CPA for vertebral plasty with TSC), group B (40 patients, only treated by TSC); The spine index, the compressed ratios of vertebral body in anterior and posterior edge, the amelioration of spinal cord and nerve function, the amelioration of low back pain and the complications of TSC such as nail breakdown of pre-operation, post-operation and follow-up period (6-16 months with mean 12 months) were observed respectively and compared. The results showed that there was no significant difference between the two groups in the spinal cord and nerve function, the spine index; there was significant difference in the compressed ratio of vertebral body in anterior edge compared the follow-up data (P<0.01), so was in the amelioration of low back pain (P<0.01); no complications were found in Group A while 4 cases occurred nail breakdown (10%) in Group B, suggesting that CPA for vertebral plasty with TSC on TCF has an advantage to reduce the losing of reshaping spine angle, the complications and the low back pain.