后路短节段椎弓根内固定加伤椎经椎弓根植骨治疗胸腰椎爆裂性骨折的初步报告  

Treatment of thoracolumbar burst fractures by short-segment pedicle instrumentation and transpedicular bone grafting

作　　者：李洪伟[1] 郭开今[1] 张翀[1] 周冰[1] 蒋允昌[1] 徐广辉[1] 陈宏亮[1] 

机构地区：[1]徐州医学院附属医院骨科,江苏徐州221002

出　　处：《徐州医学院学报》2007年第4期245-248,共4页Acta Academiae Medicinae Xuzhou

基　　金：徐州市科技局项目(2006071);徐州医学院附属医院课题(2006003)

摘　　要：目的探讨后路短节段椎弓根内固定加伤椎经椎弓根植骨治疗胸腰椎爆裂性骨折的临床疗效。方法采用短节段椎弓根内固定加伤椎经椎弓根植骨治疗胸腰椎爆裂性骨折26例，术前、术后及随访期间拍摄胸腰椎正侧位X线片，测量伤椎高度与正常高度的比值、脊柱后凸Cobb角、矢状位指数。结果术后随访12～26个月，平均14．8个月，骨折均达到满意复位并愈合，伤椎高度、Cobb角、矢状位指数均得到明显恢复，未发生内置物断裂和螺钉松动现象，也无明显矫正度丢失现象。结论后路短节段椎弓根内固定加伤椎经椎弓根植骨重建了椎体高度，增加了脊柱前柱的抗压稳定性，可有效地防止内固定失败和矫正度丢失，是一种治疗胸腰椎爆裂性骨折的有效方法。Objective To study the clinical efficacy of short - segment pedicle instrumentation combined with transpedicular intracorporeal bone grafting in the treatment of thoracolumbar burst fracture. Methods Twenty - six cases of thoracolumbar burst fractures thus treated were reviewed. Radiological evaluation was made by measuring Cobb angle, the percentage of the injured vertebra and SI after operation and during the follow - up. Results All the patients achieved fracture union during the follow - up with a mean period of 14.8 months （ range 12 - 26 months）. All of the fractures were reduced satisfactorily. The height of the injured vertebra, Cobb angle and SI were improved obviously. No fracture of screws or rods occurred, nor any screw loosening. No significant loss of correction was found. Conclusion Transpedicular intracorporeal bone grafting combined with short - segment pedicle fixation can reconstruct vertebral height and in- crease the stability of the spine, preventing implant failure and correction loss.

关 键 词：胸椎 腰椎 脊柱骨折 内固定器 骨移植 

分 类 号：R683.2[医药卫生—骨科学]