伤椎置钉联合经椎弓根椎体内植骨治疗胸腰椎骨折

目的分析伤椎置钉联合经椎弓根椎体内植骨治疗胸腰椎骨折的临床效果。方法 2008年6月至2012年6月,我院脊柱外科应用伤椎置钉联合经椎弓根椎体内植骨治疗胸腰椎骨折患者44例,对比术前、术后伤椎椎体前缘压缩比值(X线侧位片上伤椎前缘高度/伤椎相邻上下两椎体前缘高度的平均值)及脊柱后凸Cobb角;记录术前、术后的神经功能改变。结果随访时间为1.0~4.0年,平均1.8年。患者术后3 d伤椎前缘的压缩比值为93.4%,与术前的46.9%比较,差异有统计学意义(P<0.05);术后3 d的Cobb角为5.2°,与术前的30.4°比较,差异有统计学意义(P<0.05)。其中23例患者术后1年有1~3级神经功能改善。结论伤椎置钉联合经椎弓根椎体内植骨可以恢复伤椎高度并矫正脊柱后凸畸形,临床效果满意。

Transpedicular instrumentation of bone graft and vertebral pedicle screw in the treatment of thoracolumbar fractures

Objective To evaluate the clinical outcome of thoracolumbar fractures with trans-pedicular instrumentation of bone graft and vertebral pedicle screw. Methods From Jun. 2008 to Jun. 2012, a total of 44 patients with thoracolumbar fractures were implemented with transpedicular instrumentation of bone graft and vertebral pedicle screw. Preoperative and postoperative vertebral body compression ratio, and pre-operative and postoperative Cobbs angle of kyphosis were compared. Pre- operative and postoperative neurological changes were recorded. Results The patients were followed up for 1.0-4.0 years (mean 1.8 years). There was significant difference between anterior vertebral compression ratio (93.4% ) at 3rd day after the operation and preoperative vertebral compression ratio (46.9%) (P<0.05). Also, there was significant difference between Cobbs angle at 3rd day after operation (5.2°) and preoperative Cobbs angle (30.4°) (P<0.05). One year after operation, 23 patients had neural function improvement. Conclusion Pedicle screws and pedicle bone graft can restore vertebral height and correct kyphosis.