经椎弓根椎体内植骨在胸腰椎新鲜爆裂骨折治疗中的应用

目的 :探讨经椎弓根椎体内植骨在治疗胸腰椎骨折中的意义及其疗效。方法 :采用经椎弓根椎体内植骨 ,结合椎管环形减压、短节段椎弓根螺钉系统固定治疗胸腰椎新鲜爆裂骨折 76例。术前及不同随访时间行X线和CT检查 ,测量伤椎椎体中央高度值 ,比较植骨后椎体高度的恢复程度。采用配对t检验进行统计学分析。结果 :全部患者术后平均随访 13 .2个月 ,未出现植骨操作引起的神经血管并发症 ,伤椎椎体高度恢复并维持良好。伤椎椎体中央高度值与正常值比较 ,差异无显著性意义 (P >0 .0 5 )。CT显示椎体内植骨块融合良好。结论 :胸腰椎新鲜爆裂骨折在后路椎管环形减压及内固定同时经伤椎椎弓根进行椎体内植骨 ,可恢复伤椎椎体高度 ,重建前、中柱的稳定性 ,预防术后椎体塌陷的发生。

The Application of Transpedicular Intracorporeal Grafting in the Trea tment of Thoracolumbar Spinal fractures

Objective:To study the significance and long term results of transpedicular intracorporeal grafting in the treatment of thoracolumbar fractures.Methods:76 patients with thoracolumbar fractures were treated with transpedicular intracorporeal grafting,combined with circular decompression and short segmental transpedicular fixation.The middle height of the injured vertebrae was measured and were analyzed by paired Student's t test.Results:All cases were followed up 13.2 months in average.There were no neurological and vascular complications correlated with this technique.The shape and the height of the injured vertebrae were maintained and the fusion of the grafting bone was observed.There existed no significant differences between the height of reduced and normal vertebrae.Conclusion:Transpedicular intracorporeal grafting is an alternative method combined with decompression and stabilization in the treatment of thoracolumbar fractures to prevent vertebrae body from collapse postoperatively.