单节段椎弓根固定椎体内打压植骨治疗胸腰椎压缩骨折

目的探讨单节段椎弓根固定结合伤椎打压植骨治疗胸腰椎屈曲压缩骨折的疗效。方法对15例胸腰椎压缩性骨折(Denis B型)患者行后路单节段经伤椎复位固定、经椎弓根伤椎打压植骨手术。测量术前术后Cobb角,计算伤椎高度恢复率,进行ODI评分,分析疗效。结果 15例患者均获随访,时间6～18个月。伤椎高度矫正率约95%,Cobb角由术前的14°～25°改善为术后的3°～8°。未出现内固定断裂、神经损伤等并发症。结论单节段椎弓根固定椎体内植骨治疗胸腰椎压缩性骨折手术创伤小,仅固定1个运动节段;椎体内打压植骨有效解决椎体复位后产生的椎体内骨缺损。

Treatment of the thoracolumbar spine fracture with posterior monosegment pedicle fixation and transpedicular impacted bone graft at injured level

Objective To explore the clinical effects of posterior monosegmental pedicle screw fixation in selective treatment of thoracolumbar vertebral fractures.Methods 15 patients with thoracolumbar fractures were treated with posterior monosegmental pedicle screw fixation and transpedicle impacted bone graft.The Cobb′s angle and reduction of injured vertebral body height were observed.Results All cases were followed up for 6～18months.Clinical evaluation revealed that 11 cases had no pain,4 cases with occasional pain but required no medication and all patients had a high level of satisfaction with the final results.Radiographic evaluation revealed reduction rate of the injured vertebral height was 95%.The Cobb′s angle was restored from 14°～25° to 3°～8°.There was no implant breakage,and no signs of pseudoarthrosis were observed.Conclusions Posterior monosegmental fixation might be an adequate and effective procedure to be used in specific types of thoracolumbar spine fractures.Transpedicular impacted grafting after bone loss calculation combined with pedicle fixation has better biomechanical properties.