经一侧伤椎短节段椎弓根固定联合椎体内植骨治疗胸腰段椎体骨折

目的 探讨经一侧伤椎短节段椎弓根固定联合椎体内植骨治疗胸腰段椎体骨折的可行性及疗效.方法 将自2005年1月～2009年5月行短节段椎弓根钉固定联合椎体内植骨治疗的102例胸腰段椎体骨折随机分为两组.A组行后路短节段椎弓根钉固定结合经一侧伤椎椎弓根固定联合椎体内植骨,B组行后路跨伤椎短节段椎弓根钉固定联合椎体内植骨.结果 本组获随访12～24个月.术后1周后凸Cobb角、椎体前缘高度两组间比较,差异无统计学意义(P＞0.05),末次随访时A组矫正角度、椎体前缘高度丢失量明显小于B组,差异有统计学意义(P＜.05).B组末次随访时腰背痛发病率以及内固定失败率明显高于A组,差异有统计学意义(P＜0.05).结论 经一侧伤椎短节段椎弓根固定联合椎体内植骨治疗胸腰段椎体骨折是一种有效的方法.

Short-segment pedicle screw fixation with screw placed at single injured vertebrae combined with transpedicular intracorporeal grafting for thoracolumbar fractures

Objective To explore feasibility and curative effect of treatment of thoracolumbar fractures by using short-segment pedicle screw fixation with screw placed at the single injured vertebrae and grafting through the injured pedicle.Methods 102 cases of thoracolumbar fracture were treated by using short-segment pedicle screw fixation combined with transpedicular intracorporporeal grafting from January 2005 to May 2009.Group A was fixed with screw placed at the single pedicle of the injured vertebrae,group B was fixed with short-segment pedicle screw over the injured vertebrae.Results The patients were followed up for 12～24 months.The difference in Cobb’s angle and anterior margin height of fractured vertebra after operation was not significant between the two groups(P >0.05).The Cobb’s angle and anterior margin height of fractured vertebra were less lost in the group A than the group B at last follow-up,the difference was significant(P <0.05).The incidence rate of lumbodorsal pain and internal fixation failure of group A were lower than group B,the difference was significant(P <0.05).Conclusion Short-segment pedicle screw fixation with screw placed at the single injured vertebrae combined with transpedicular intracorporeal grafting is a good method of treating thoracolumbar fractures.