后路椎弓根内固定联合椎体内植骨治疗胸腰段爆裂性骨折的临床分析  

作　　者：江孝龙 蒋国华 石钢 

机构地区：[1]浙江省荣军医院(嘉兴市第三医院),314000

出　　处：《浙江临床医学》2019年第6期755-756,759,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 观察后路椎弓根内固定联合椎体内植骨治疗胸腰段爆裂性骨折的临床疗效.方法 选取本院收治的48例胸腰段爆裂性骨折患者作为研究对象,所有患者均实施后路椎弓根内固定联合椎体内植骨治疗.观察治疗期间围手术期指标、神经功能情况、影像学指标,统计并发症发生率情况.结果 本组患者平均手术时间(102.35±10.24)min,平均术中出血量(221.73±35.20)ml,平均骨折愈合时间(5.67±1.28)月.术后6个月、术后1年后凸Cobb角、椎管狭窄率明显低于术前,伤椎前缘高度比明显高于术前(P<0.05).术前神经功能分级为A级4例,B级9例,C级13例,D级22例,E级0例;术后1年A级0例,B级1例,C级2例,D级4例,E级41例.术后出现切口感染1例,内固定松动1例,并发症发生率为4.17%.结论 后路椎弓根内固定联合椎体内植骨能够促进胸腰段爆裂性骨折患者神经功能恢复,恢复椎体前缘高度,改善椎管狭窄程度.Objective To observe clinical effect of posterior pedicle screw fixation combined with intravertebral bone graft in treatment of thoracolumbar burst fractures.Methods Forty-eight cases of patients with thoracolumbar burst fractures treated in our hospital were selected as the study objects.All patients in this group were treated with posterior pedicle screw fixation and vertebral bone graft.The indexes of perioperative indicators during treatment,neurological status,imaging indicators,statistical complication rates were observed.Results The mean operative time was(102.35±10.24)min.The blood loss was(221.73±35.20)ml and the healing time was(5.67±1.28)months.The Cobb angle and spinal canal stenosis rate at 6 months and 1 year after operation were significantly lower than those before operation,anterior vertebral height at 6 months and 1 year after operation was significantly higher than that before operation(P<0.05).Preoperative neurological grading was grade A in 4 cases,grade B in 9 cases,grade C in 13,grade D in 22,and grade E in 0;grade 1 in grade A after 0,grade B in 1,grade C in 2,grade D Grade 4 cases,grade E 41 cases.Incision infection occurred in 1 case,internal fixation loose in 1 case,the complication rate was 4.17%.Conclusion Posterior pedicle screw fixation combined with intravertebral bone graft can promote the recovery of neurological function of patients with thoracolumbar burst fractures,restore anterior vertebral height,and improve spinal stenosis.

关 键 词：后路椎弓根内固定 植骨 胸腰段爆裂性骨折 临床疗效 伤椎前缘高度 

分 类 号：R6[医药卫生—外科学]