后路经椎弓根内固定结合椎体成形术治疗老年胸腰段脊椎骨折的疗效观察

目的:观察评价后路经椎弓根内固定结合椎体成形术治疗老年胸腰段脊椎骨折的手术疗效。方法:选取46例于2010年1月至2012年4月间我院收治的老年胸腰段脊椎骨折患者作为观察组,行后路经椎弓根内固定结合椎体成形术。另取46例无神经症状的患者(对照组)行单纯后路经椎弓根内固定。对所有患者均进行随访6~12个月,观察手术疗效及相关指标情况。结果:术后两组患者伤椎前缘高度及Cobb's角较术前均有明显改善(P<0.05)。对照组手术优良率为25例(54.3%),实验组为39例(84.8%),后者显著优于前者(P<0.05)。对照组术后内固定松动、断裂发生率显著高于实验组(P<0.05)。结论:老年胸腰段脊椎柱骨折采取后路经椎弓根内固定结合椎体成形术治疗效果显著,内固定失败率低,可在临床推广试用。

Clinical effect observation of posterior pedicle internal fixation combined with vertebral plasty for treatment of thoracolumbar spine fractures in the elderly patients

Objective:To observe and evaluate the operative clinical effect of posterior pedicle internal fixation combined verte-bral plasty for treatment of thoracolumbar spine fractures of the elderly.Methods:Ninety-two elderly patients with thoracolumbar spine fractures were chosen as research objects and divided into control group and experiment group according to the neurologic symptoms with 46 cases in each.The patients were failure of conservative treatment and received operation.Control group was given pure posterior pedicle internal fixation and experiment group was given posterior pedicle internal fixation combined vertebral plasty.All patients were given 6 to 12 months follow-ups and given routine X-ray,CT and MRI examinations.Vertebral anterior height (%)and Cobb′s angle, operative clinical effect and postoperative loosening and breakage conditions of internal fixation of the 2 groups were observed and com-pared.Results:After operations,vertebral anterior height and Cobb′s angle of the 2 groups were both obviously improved (P <0.05), but no significant differences existed between groups (P <0.05 ).Excellent and good rate of operation of control group was 54.3%(25 /46)and experiment group was 84.8% (39 /46),experiment group was obviously higher than control group (P <0.05).After op-eration,in control group there were 8 cases with internal fixation loosening and 3 cases with breakage,the occurrence rate was 23.9%, while in experiment group,there were 1 case of loosening,the occurrence rate was 2.2% obviously lower than that of control group (P <0.05).Conclusion:Posterior pedicle internal fixation combined with vertebral plasty for treatment of thoracolumbar spine frac-tures of the elderly has an obvious clinical effect and a low failure rate of internal fixation,so it can be popularized in clinical applica-tion.