椎弓根螺钉内固定结合经伤椎弓根椎体植骨治疗腰椎骨折22例

目的：观察经皮椎弓根螺钉内固定结合伤椎椎弓根椎体植骨治疗腰椎骨折的临床效果。方法选取43例腰椎骨折患者并采用信封法随机分为两组，对照组21例采用单纯椎弓根螺钉内固定治疗，观察组22例在对照组基础上结合伤椎椎弓根椎体植骨伤椎植骨，观察两组患者的手术情况、住院时间，同时随访两组患者1年，观察两组患者治疗前后椎体前缘高度、后凸Cobb角及Worter指数的变化。结果两组患者的手术情况及住院时间、术前椎体前缘高度、后凸Cobb角及Worter指数比较差异均无统计学意义（P＞0.05），但1年后随访时，观察组椎体前缘高度明显高于对照组，后凸Cobb角及Worter指数均明显低于对照组，经比较差异均具有统计学意义（P＜0.05）。结论椎弓根螺钉内固定结合经椎椎弓根椎体植骨治疗腰椎骨折不仅具有微创安全的特点，而且可提高伤椎椎体生物力学稳定性，减少术后椎体高度的丢失。

Pedicle screw fixation combined with pedicle bone graft in treating 22 cases of vertebral fracture

Objective To explore the clinical effect of percutaneous pedicle fixation and bone grafting in treating vertebral fracture. Methods 43 cases of vertebral fracture patients were randomly divided into control group and observation group by using envelopes. 21 cases in control group were treated with pedicle screw fixation alone, while 22 cases in observation group were treated with pedicle screw fixation combined with bone graft. The operation status and hospital stay were observed. All the patients were followed up for 1 year to observe the changes of anterior vertebrate height, kyphosis Cobb angle and Worter vertebral index before and after treatment. Results There were no significant differences between the two groups in operation status, hospital stay, anterior vertebrate height, kyphosis Cobb angle and Worter vertebral index （P〉0.05）, but after 1-year follow-up, the anterior vertebral height in observa-tion group was significantly higher than that in control group, the kyphosis Cobb angle and Worter index were signifi-cantly lower than those in the control group （P〈0.05）. Conclusion The minimally invasive treatment of vertebral fracture with pedicle screw fixation combined with pedicle graft is not only safe, but also improve the biomechanical stability of vertebral body and reduce the loss of vertebral height.