经骨折椎椎弓根固定治疗胸腰椎爆裂骨折

目的分析和探讨经骨折椎椎弓根固定治疗胸腰椎爆裂性骨折的可行性及临床疗效。方法回顺性分析我科月2001年12月至2006年6月收治的64例单椎体胸腰椎爆裂性骨折患者的临床资料．其中单纯行跨骨折椎的4钉固定术（A组）34例．包括骨折椎椎弓根固定的6钉固定术（B组）30例。随访12～36个月（平均18．3个月）．分别从病人骨折椎前缘高度、矢状面Cobb角、神经功能恢复、内固定失败率（断钉、断棒及退钉等）及腰背痛方面进行评价。结果虽然两组的骨折椎前缘高度和矢状面Cobb角的即刻改善无明显差别（P〉0．05）．但B绢的骨折擀前缘高度和矢状面Cobb角均优于A组（P〈0．05）。两组的神经功能评定比较差异无统计学意义。B组较A组有较低的崾背疼痛及内固定失败率。结论经骨折椎椎弓根固定治疗胸腰椎爆裂性骨折是切实可行及有效的方法．仉得临床探讨应用。

Treatment of Thoracolumbar Burst Fractures with Fixation through the Pedicle of Fractured Vertebra

Objective To analyze and investigate the feasibility and clinical therapeutic efficacy of reduction and fixationthrougb the pedicle of fractured vertebra in treatment ofthoracolumbar burst fractures. Methods Clinicalda ta of 64 eases of one level thoracolumbar burst fracture in our department from December 2001 to June 2006 were retrospectively analyzed. All the cases were followed up for 12 to 36 months（18. 3 months on average）.and two groups were comparative analyzed from five aspects,that is fractured vertebra height,the Cohh＇angle,nerve functions,interhal fixation failure and back pain. Results While the fractured vertebral height and the Cobh＇s angle of two groups had no significant difference immediately（P〉0.05）,B group was obviously better than A group（P〈0. 05）. The nerve functions of two groups hadn＇t significant difference ,and B group had lower rates of back pain and internal fixafion failure. Conclusion Reduetion and fixation through the pedicle of fractured vertebra was an effective therapeutic options to treat the thoracolumbar burst fractures and deserved clinical study and expansion.