经伤椎植骨并椎弓根钉内固定术治疗胸腰椎骨折

目的：探讨经骨折椎椎弓根椎体内植骨并椎弓根钉内固定术治疗胸腰椎骨折的临床疗效。方法2008年1月～2012年12月收集105例胸腰椎骨折患者，均采用经骨折椎椎弓根椎体内植骨加椎弓根钉内固定术治疗。术前、术后测量椎体前缘压缩率、椎管狭窄率、椎体Cobb角及并发症情况。结果105例患者随访12～36个月，平均19个月。术前、术后及末次随访时伤椎前缘压缩率分别为（36．0±12．1）％、（3．8±2．4）％、（3．8±3．0）％；椎管狭窄率分别为（35．6±9．0）％、（10．9±3．7）％、（10．7±3．4）％；Cobb角分别为33．6°±8．7°、3．1°±2．0°、3．2°±2．5°；术后及末次随访时各观察指标均较术前改善，差异有统计学意义（P＜0．05）。无内固定失败并发症。结论经骨折椎椎弓根椎体内植骨加椎弓根钉内固定手术，对骨折椎椎体复位效果好，减少内固定失败并发症。

Pedicle screw internal fixation combined with intra-vertebral bone graft for thoracolumbar fractures

Objective To evaluate the clinical effect of short-segment pedicle instrumentation combined with transpedicular intra-vertebral bone graft for the treatment of thoracolumbar fractures.Methods From January 2008 to December 2012, 105 consecutive patients with thoracolumbar fractures underwent short-segment pedicle instrumentation combined with transpedicular intra-vertebral bone graft. The compression ratio of vertebral anterior edge, spinal stenosis ratio and vertebral Cobb's angle were measured before and after surgery. Complications were also observed. Results All patients were followed up for 19 months averaged (12-36 months). The compression rate of anterior vertebral border restored from (36.0±12.1)% preoperatively to (3.8±2.4)% postoperatively and (3.8±3.0)% at the final follow-up. Spinal stenosis rate restored from (35.6±9.0)% preoperatively to (10.9±3.7)% postoperatively and(10.7±3.4)% at the final follow-up. Kyphotic deformity improved from 33.6°±8.7° preoperatively to 3.1°±2.0° postoperatively and 3.2°±2.5° at the final follow-up. Complications such as internal fixation failure were not found. Conclusion Short-segment pedicle instrumentation combined with transpedicular intra-vertebral bone graft is benefit for vertebral reduction and decrease complications of internal fixation failure for the treatment of thoracolumbar fractures.