经椎弓根植骨技术治疗胸腰椎骨折  

Bone Grafting across Transpedicalar for the Treatment of Thoracolumbar Burst Fracture

作　　者：王景续 杨冬 郭勇[1] 单军[1] 邬波[1] 

机构地区：[1]辽宁省沈阳市骨科医院,辽宁沈阳110044

出　　处：《中国临床医学》2007年第2期238-239,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:总结治疗胸腰椎爆裂骨折的经验,以减少术后并发症。方法:26例胸腰椎爆裂骨折病例,其中男性18例,女性8例;年龄19～59岁。损伤节段:T11 1例,T12 5例,L19例,L26例,L3 2例,L4 3例。伤后至手术时间3～16 d,均为爆裂骨折。术前椎管占位率35％～80％。脊柱后突程度(Cobb角):18°～40°。椎体高度压缩至正常的20％～58％。Frankel分级:A级2例,B级4倒,C级6例,D级5例,E级9例。治疗按置钉→减压→复位→植骨步骤进行。结果:随访1～4年,未发现继发后凸畸形,椎体高度恢复至正常的80％～100％,椎管占位率10％～25％。脊柱后突程度(Cobb角)平均3°,Frankel分级:A级1例,B级2例,C级3例,D级5例,E级15例。结论:经椎弓根植骨椎弓根螺钉固定治疗胸腰椎骨折,可在早期稳定的基础上为前柱提供长期稳定,避免因复位后“蛋壳”椎体的形成,从而减少术后并发症。Objective：To summerize the clinical experience of the treatment of thoracolumbar fracture for decreasing failure rate in thoracolumbar burst fracture operation. Methods：Clinical data of 26 patients with thoracolumbar burst fracture were reviewed. Among them 18 were male and 8 female, age range was 19-59, injure segment were T11 1 cases,T12 5 cases, LI 9cases, L2 6 cases,L3 2cases and L4 3 cases. There were 3-16 days from injure to operation. All were thoracolumbar burst fracture. The percentage of fragment in the spinal canal was 35% -80% before operation. The percentage between the height of the injured spine and that of the normal spine was 20%-58%. The Frankel classfication were 2, 4, 6, 5 and 9 cases in Grade A, B, C, D and E, respectively. Operation step was pedicle screw fixation → decompression→reduction → bone grafting. Results： All of the cases were followed up for 1-4 years. There were no post-traumatic kyphosis. Vertebral body height improved completed recovery or almost between 80%-100%. The percentage of fragment in the spinal canal is 10%-25%. The average of Cobb＇s angle was 3°. The Frankel classification were A Grade： 1 cases, B Grade： 2 cases, C Grade： 3 cases, D Grade： 5 cases, E Grade： 15 cases. Conclusion：Bone grafting across transpedicalar pedicle screw fixation in the treatment of thoracolumbar burst fracture increase the stability of the anterior column of spinet decrease the rate of failure in thoracolumbar burst fracture operation.

关 键 词：经椎弓根植骨 胸腰椎爆裂骨折 

分 类 号：R683.2[医药卫生—骨科学]