后路椎弓根螺钉内固定结合椎体成形术治疗中老年胸腰椎爆裂性骨折30例

目的：探讨经后路椎弓根螺钉内固定结合椎体成形术治疗中老年胸腰椎爆裂性骨折的临床疗效及并发症。方法选择30例中老年胸腰椎爆裂性骨折患者，采用经后路椎弓根钉内固定结合椎体成形术治疗，观察术后骨折复位及骨水泥充盈，内固定有无断裂、松动等并发症，并分别于术前、术后1周、术后1年取钉时统计伤椎后凸畸形角（Cobb角）、伤椎前缘与后缘高度的比值，以及对腰背痛症状采取视觉模拟评分(VAS评分)比较分析。结果术后患无内固定松动、断裂、椎体塌陷等并发症。术前与术后伤椎前缘高度与椎体后缘高度的比值、Cobb 角、VAS 评分相比差异有统计学意义(P<0.05)，术后1周与术后1年取钉时伤椎前缘高度与椎体后缘高度的比值、脊柱后凸 Cobb 角、腰背疼痛 VAS 评分比较无明显差异(P>0.05)。结论经后路椎弓根螺钉内固定结合椎体成形术治疗中老年胸腰椎爆裂性骨折，可重建脊柱稳定，缓解腰背部疼痛，减少椎弓根螺钉内固定的并发症，长期疗效满意。

30 Cases of Elderly Thoracolumbar Bursting Fractures Treated with Posterior Pediele Screw Fixation and Vertebroplasty

Objective To explore the clinical efficacy and complications of elderly thoracolumbar bursting fractures treated with posterior pediele screw fixation and vertebroplasty. Methods Thirty cases of elderly thoracolumbar bursting fractures were collected. The pedicle screw fixation and vertebroplasty after menstruation were adopted. The complications such as reduction, cements, breakage and looseness of internal fixation were observed. The vertebral heights of the anterior and posterior borders of vertebra and Cobb angle, as well as visual analogy score (VAS) before sugery, one week after surgery, one year after surgery were assessed statistically. Results No looseness and breakage of internal fixation, vertebral collapse after surgery were found. The ratios between the vertebral heights of the anterior and posterior borders of vertebra, Cobb angle and VAS after surgery were significantly different (P<0.05) compared with those before surgery. The ratios between the vertebral heights of the anterior and posterior borders of vertebra, Cobb angle and VAS at the moment of screw removal in 1 year of surgery were not statistically significant (P>0.05) compared with those 1 week after surgery. Conclusion The posterior pediele screw fixation and vertebroplasty in treating elderly thoracolumbar bursting fractures can reconstruct the stability, alleviate back pain, effectively decrease the complications of pediele screw fixation, achieve the definite efficacy.