椎弓根螺钉系统加自固化磷酸钙人工骨灌注治疗胸腰椎骨折

目的探讨应用椎弓根螺钉系统及自固化磷酸钙人工骨（ACPC）灌注治疗胸腰椎骨折的效果。方法1999年4月始，选择18例胸腰椎骨折患者，其中压缩型12例，爆裂型6例。伤后6h～7d行椎弓根螺钉系统固定、复位，同时加ACPC灌注伤椎。结果18例患者除2例神经功能A级脊髓神经症状无改善外，其余均有Ⅰ～Ⅲ级的恢复，脊柱后凸角平均恢复21°，伤椎前缘高度平均恢复至98％，伤椎后缘侵入椎管骨块明显回纳。随访10～16个月，平均11.6个月。随访期间无内固定松动及断裂现象，无慢性腰背痛，伤椎高度及脊柱生理弧度无丢失。结论胸腰椎压缩型骨折是使用ACPC的最佳适应证。如术前影像检查明确有双侧椎弓根骨折，则为禁忌。只要手术适应证选择适当，术中操作仔细，椎弓根螺钉系统加ACPC灌注治疗胸腰椎骨折是一有效而又安全的方法，特别是后期伤椎高度和脊柱生理弧度得到很好的维持。

Treatment of thoracolumbar vertebrae fractures with vertebral pedicle screw system and artificial bones filled with autosolidification calcium phosphate cement

Objective　To study the effect of vertebral pedicle screw system and artificial bones filled with autosolidification calcium phosphate cement(ACPC) on thoracolumbar vertebrae fractures. 　Methods　A total of 18 patients with thoracolumbar vertebrae fractures and with operative indications were treated with vertebral pedicle screw system and artificial bones filled with ACPC. 　Results 　Except 2 patients with the spinal cord function for Grade A, all the patients had the average improvement of Degree I to Degree Ⅲ on the aspect of spinal cord function. The kyphotic angle recovered averagely for 21°, the anterior height of the injured vertebral body was averagely restored to 98% of the normal, and the bone fragments that invaded into the spinal canal were obviously restored. During the following-up, loose or breakage of the internal fixation was not found, and there was no chronic lumbar back pain or loss of the normal spine curve and the spinal height of the injured vertebra. 　Conclusions　With correct selection of operative indications and careful operations, the method with vertebral pedicle screw system and artificial bones filled with ACPC to treat thoracolumbar vertebrae fractures is an effective and safe method.