短节段固定附加伤椎椎弓根植骨或经伤椎固定治疗老年胸腰椎骨折

目的:探讨后路短节段固定附加伤椎椎弓根钉固定或伤椎经椎弓根植骨治疗老年胸腰段脊柱骨折的临床疗效。方法:32例患者实施后路短节段固定术基础上,分别附加开展了11例患者伤椎固定和21例椎弓根椎体植骨椎体成形术。观察两组患者术后椎体前后缘压缩率变化情况,Cobb角矫正程度。结果:术后随访11～35个月,平均16.2个月。骨折椎体前后缘均恢复满意,ASIA评分为A级的2例病例无明显改善,其余患者均有明显的恢复,改普程度平均达1.5级。两组在手术时间、出血量、住院天数、X线术前术后半年评估、并发症、疼痛、运动节段活动、后凸畸形矫正率等对比显示,两组在失败率和畸形矫正率上无明显差异。结论:短节段固定附加伤椎椎弓根植骨或经伤椎固定治疗老年胸腰椎骨质疏松性骨折,减少手术并发症并降低了手术失败风险,可进一步放宽手术适应证。

Observation on Posterior a Short-Segment Fixed with Additional Vertebral Pedicle Nail Fixed or Transpedicular Bone Grafting in the Treatment of Thoracolumbar Fracture

Objective:Explore the clinical curative effect of posterior a short-segment fixed with additional vertebral pedicle nail fixed or transpedicular bone grafting in the treatment of thoracolumbar fracture.Methods:Of the 32 patients who were followed posterior a short-segment fixed operation,11 patients had a vertebral pedicle nail fixed operation,the remaining 21 cases had a transpedicular bone grafting. Observe change of the compression ratio of leading and trailing edge of the vertebral body,the correction degree of Cobb angle.Results: Postoperative follow-up is a minimum of 11 months(range,11.0 to 35.0 months;mean 16.2 months).Every leading and trailing edge of the vertebral body is recovered satisfactorily.2 cases with ASIA score for A grade had no obvious improvement,all the others had recovered obviously,with mean improvement degree of 1.5 grade.The comparison in operative time,blood loss,hospital days,X-ray evaluation of postoperative recovery after half a year,complications,pain,motion segment activities,correction ratio of kyphosis of the two groups indicates, there were no apparent differences in the failure ratio and correction ratio of deformity.Concluslon:Posterior a short-segment fixed with additional vertebral pedicle nail fixed or transpedicular bone grafting in the treatment of thoracolumbar fracture,can reduce the surgical complications and the risk of operation failure,thus the surgical indications can be further relaxed.