后路椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折临床观察

目的 探讨经椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折的临床疗效.方法 收集2008年3月至2011年3月在我科住院并采用经椎弓根内固定结合椎体成形术治疗的22例老年胸腰椎骨折患者的临床资料,回顾性分析术前、术后1周和末次随访时骨折复位和稳定情况.结果 所有患者均顺利完成手术,术后按照Frankel分级法,神经功能均恢复至E级.所有病例术后均获得随访,随访时间8～28个月,平均随访20个月.术后末次随访脊柱后凸Cobb's角、椎体前缘、椎体后缘高度压缩率,与术前比较,差异均有统计学意义(均P<0.05),未发生内固定松动断裂,术后腰背部无明显疼痛.结论 后路经椎弓根内固定结合椎体成形术是治疗老年胸腰段脊柱骨折的有效方法,可减少术后内固定松动、断裂等并发症的发生,值得临床推广.

Posterior pedicle screw fixation with vertebroplasty for thoracolumber fractures in the senior

Objective: To evaluate the curative effect of posterior pedicle screw fixation with vertebroplasty for thoracolumbar fractures in the aged.Methods: From March 2008 to March 2011,22 patients with thoracolumbar fractures were operated by posterior transpedicular internal fixation combined with vertebroplasty.The symptom improvement was observed.Plain X-rays were taken at pre-operation and post-operation and final follow-up to determine the improvement of the injured vertebral height and Cobb’s angle.Results: All the patients underwent surgery uneventfully.22 patients were followed up for an average of 20 months.After operation Frankel Grading System improved to Grade E.The last follow-up Cobb’s angle of kyphosis,vertebral,vertebral height compared with the preoperative compression ratio,the differences were statistically significant(P<0.05).There was no breakage of pedicle screw or loosening of instrument.Conclusion: The combination of posterior transpedicular internal fixation system and vertebroplasty is a feasible and effective method for thoracolumbar fractures in the aged patients.It can decrease the instrument failure rate,and provide better postoperative outcomes.