28例胸腰椎骨质疏松性骨折经椎弓根椎体内植骨加短节段内固定术治疗  

Treatment of the transpedicular intervertebral bone graft after posterior pedicle screw fixation of thoracolumbar osteoporotic fractures in 28 cases

作　　者：李茂廷[1] 张智海[1] 李学民[1] 文海照 吴国平[1] 

机构地区：[1]航空工业中心医院骨科,北京100012

出　　处：《中国骨质疏松杂志》2008年第9期689-690,684,共3页Chinese Journal of Osteoporosis

摘　　要：目的总结治疗胸腰段脊柱骨折经椎弓根椎体内植骨加短节段内固定术治疗的经验,以减少术后并发症。方法28例胸腰段脊柱骨折病例,其中男性19例,女性9例;年龄63-75岁,平均（67±5.6）岁。损伤节段：骨折节段：T11骨折1例,T12骨折8例,L1骨折11例,L2骨折5例,L3骨折3例。伤后至手术时间平均（3±1.6）d,均为爆裂骨折。术前的后凸畸形为（25±6.2）度,矢状位系数（SI（saggital index）=伤椎椎体前高/相邻两个椎体前高的平均值）：伤前平均为31%,治疗按置钉、复位、经椎弓根植骨步骤进行。结果手术后平均（14±1.6）个月取钉,内固定取出后随访平均（5±2.8）个月,所有骨折椎体得到骨性愈合,后凸畸形术后矫正至（5.5±1.1）度,矢状位系数术后恢复至93.56%。结论经椎弓根植骨椎弓根螺钉固定治疗胸腰椎骨质疏松性骨折,可在早期稳定的基础上为前柱提供长期稳定,避免因远期后凸并发症形成,从而取得良好效果。Objective To summarize the clinical experience of the treatment of the transpedicular intervertebral bone graft after posterior pedicle screw fixation of thoraeolumbar fractures in 28 eases. Methods 28 cases with thoracolumbar burst fracture were reviewed. Among them 19 were male and 9 female, age range was 42 ± 5.6 years（23-63 years）. The injure segments were T11 1 cases, T12 8 cases, L1 11 cases, L2 5 cases, L3 3 cases. There were average 3 ± 1.6 days from injury to operation. All were thoracolumbar burst fracture. Before the operation, the spinal average of Cobb＇s angle was 25 ± 6.2 degree, and the saggital index was 31% （SI = the anterior height of the fracture vertebra/the average value of the anterior height of two nearest segments）. Operation steps were pedicle screw fixation, reduction and transpedicular intervertebral bone graft. Results The entire internal fixations were moved out after operations 14 ± 1.6 mouths later. All of the cases were followed up for 5 ± 2.8 months since the internal fixation moved out bodies and got bone fusion fully. The spinal average of Cobb＇s angle was 5.5 ± 1.1 degree, and the saggital index was 93.56 % . Conclusion The transpedicular intervertebral bone graft after posterior pedicle screw fixation of thoracolumbar fractures can increase the stability of the anterior column of spine, and prevent long term kyphosis deformity.

关 键 词：胸腰段 脊柱骨折 经椎弓根植骨 内固定术 

分 类 号：R683.2[医药卫生—骨科学]