后路椎弓根螺钉固定加经椎弓根注射型硫酸钙植骨治疗胸腰椎爆裂性骨折

目的观察经椎弓根注射型硫酸钙植骨对预防胸腰椎爆裂性骨折椎弓根钉固定失败的作用及意义。方法本组66例胸腰椎爆裂性骨折患者随机分成2组：A组（行短节段内固定并辅助经椎弓根注射型硫酸钙植骨）33例，B组（仅行短节段内固定）33例。平均随访16个月，在侧位X线片上测量Cobb角、伤椎后凸角以及伤椎相对高度，功能评定采用Greenough腰痛评分法（lowback outcome score，LBOS）。结果手术前、后2组间Cobb角、伤椎后凸角以及伤椎相对高度差异无统计学意义（P〉0．05），而末次随访2组问Cobb角、伤椎后凸角以及伤椎相对高度差异有统计学意义（P〈0．01）。LBOS评分，A组优良率为85％（28／33），B组仅为60％（20／33）。结论经椎弓根注射型硫酸钙植骨是降低内固定失败、减少伤椎高度丢失、后凸畸形等并发症的有效措施。

The treatment of thoracolumbar burst fracture with pedicle screw fixation combined the calcium sulfate bone graft injected through pedicle

Objective To explore the function of preventing pedicle screw fixation failure in thoracolumbar burst fracture treated with transpedicular injectable calcium sulfate bone grafting. Methods The present study included 66 patients with thoracolumbar burst fracture, which were divided into 2 groups. Group A (short-segment pedicle screw fixation combined with injectable calcium sulfate bone grafting) had 33 cases; Group B (short-segment pedicle screw fixation) had 33 cases. The average follow-up period was 16 months. The Cobb's angle, kyphotic Cobb's angle and the relative height of the injured vertebra were measured on the lateral X-rays. Low back outcome score (LBOS) developed Greenough was used in the functional assessment. Results There were no significant difference between the 2 groups in the Cobb's angle, kyphotic angle and the relative height of the injured vertebra before surgery and immediately after surgery (P>0.05). But there were significant difference between the 2 groups in the Cobb's angle, kyphotic angle and the relative height of the injured vertebra at the last follow-up. The good-excellent rate was 85% (28/33) in Group A, and 60% in Group B. Conclusion Transpedicular injectable calcium sulfate bone grafting was an effective measure for reducing the failure rate of fixation, the loss of vertebral height and kyphosis deformity.