椎体内植骨并椎弓根内固定治疗胸腰椎骨折  

Intravertebral Bone Graft with Vertebral Pedicle Internal Fixation for the Treatment of Thoracolumbar Fractures

作　　者：吴明宇[1] 申小青[1] 张绪华[1] 覃励明[1] 

机构地区：[1]怀化医学高等专科学校附属医院暨怀化市第三人民医院,湖南怀化418000

出　　处：《医学临床研究》2011年第4期665-667,共3页Journal of Clinical Research

基　　金：2007年怀化市科技创新型人才培育计划课题,项目编号：怀科发2007年24号文件〈肆-1〉

摘　　要：【目的】评价椎体内植骨并椎弓根内固定治疗胸腰椎骨折的临床疗效。【方法】对本院75例采用椎体内植骨或后路植骨椎弓根螺钉内固定治疗胸腰椎骨折术式进行比较，其中40例采用椎体内植骨，35例采用后路植骨，分别测量术前、术后1周、术后12个月、术后18个月（去除内固定后6个月）以下指标：节段性后凸Cobb角、椎体前缘高度压缩比、伤椎椎弓根层面松质骨CT值，并进行分析比较。【结果】术后18个月椎体内植骨组节段性后凸Cobb角、椎体前缘高度压缩比、伤椎椎弓根平面松质骨CT值指标均显著优于后路植骨组（P〈0．05）。【结论】椎体内植骨并椎弓根内固定治疗胸腰椎骨折疗效优于传统椎弓根内固定并后外侧植骨，且具有操作可行、安全性高、成本较低的优点。[Objective] To evaluate the clinical efficacy of intravertebral bone graft and vertebral pedicle internal fixation for the treatment of thoracolumbar fractures. [Methods] Totally 75 patients with thoracolumbar fracture were treated by intravertebral bone graft or posterior bone graft combined with vertebral pedicle internal fixation in our hospital from May 2006 to July 2009. Among all patients, 45 patients were treated by intra- vertebral bone graft and 35 patients were treated by posterior bone graft. The following indexes such as seg- mental Cobb angle, compression ratio of vertebral anterior border height and CT value of cancellous bone of injuring vertebral pedicle were analyzed and compared before, 1 week, 12 and 18 months after operation（6 months after removing internal fixation）. [Results] At 18 months after operation or 6 months after removing internal fixation, the segmental Cobb angle, the compression ratio of vertebral anterior border height and CT value of cancellous bone of injuring vertebral pedicle in intravertebral bone group were better than those in pos- terior bone graft group（ P〈0.05）. [Conclusion] Intravertebral bone graft combined with vertebral pedicle internal fixation for the treatment of thoracolumbar fractures is better than traditional Vertebral pedicle internal fixation combined with posterolateral bone graft, and has the advantages of convenient operation, high security and low costs.

关 键 词：脊柱骨折/外科学 胸椎/外科学 腰椎/外科学 骨折固定术 内 

分 类 号：R683[医药卫生—骨科学]