胸腰椎爆裂性骨折椎弓根内固定并不同植骨方法临床分析  

Thoracolumbar fractures treated with pedicle screw fixation and bone grafting methods in different clinical analysis

作　　者：张鹏[1,2] 王丽雅[2] 魏开斌[2] 

机构地区：[1]青岛大学医学院,山东266021 [2]泰安市中心医院,山东271000

出　　处：《社区医学杂志》2011年第8期8-10,共3页Journal Of Community Medicine

摘　　要：目的探讨经椎弓根自体骨植骨并椎弓根钉内固定治疗胸腰椎爆裂性骨折的疗效及其疗效影响因素;分析不同的植骨方法在胸腰椎爆裂骨折治疗中的差异。方法回顾性分析泰安市中心医院骨外科2005年12月-2009年12月共64例胸腰椎爆裂性骨折住院病人,比较经椎弓根椎体内植骨,椎板间植骨和单纯内固定无植骨的术后即时及随访的临床效果,并根据影像学、神经功能和临床症状进行分析评价。结果 64例病人术后随访12个月,经椎弓根椎体内植骨组术后椎体前缘高度及术后后凸成角丢失少,内固定失效率低,与椎板间植骨组和单纯内固定无植骨组具有统计学差异(P<0.05)。结论经后路椎弓根钉系统内固定加经椎弓根自体骨植骨能即时增加椎体骨容量和脊柱前柱的抗压稳定性,有效纠正椎体畸形,减少椎体再压缩及内固定因应力过大造成的断钉、断杆等并发症,使患者早期活动,是一种治疗胸腰椎爆裂性骨折预防矫正丢失的有效方法。Objective To explore the pedicle autogeneous bone grafts and using pedicle screws treatment of thoracolumbar burst fracture and its effect factors affecting the curative effect.Analyze the different methods of the graft in thoracolumbar burst fracture for clinical treatment of differences.Methods TaiAnShi central hospital were retrospectively analyzed bone surgery in December 2005~December 2009,64 cases of thoracolumbar burst fracture patients hospitalized.Compare malposition vsertebral body bone graft,lamina between bone graft fixation and simple without bone graft postoperative instant and follow-up clinical effect.According to the imaging and neural function and clinical symptoms were evaluated.Results 64 patients follow-up of 12 months.Malposition vsertebral body bone graft group began vertebral devices,edge height and postoperative protruding after into horns lost less,low failure rate between vertebral lamina bone graft fixation group and pure without bone graft group has statistically significant（P0.05）.Conclusions The pedicle screw systems posterior fixation plus malposition autogeneous bone grafts can instantly increases vertebral bone capacity and spinal QianZhu compressive stability,effectively correct vertebral malformation,reduce vertebral further compression and internal fixation for stress caused by screw breakage,broken rod complications such as,so that patients early activity,it is a kind of treatment of thoracolumbar burst fracture prevention correction lost effective methods.

关 键 词：经椎弓根植骨 胸腰椎爆裂骨折 椎弓根钉固定术 

分 类 号：R683.2[医药卫生—骨科学]