经椎弓根植骨治疗胸腰椎爆裂性骨折疗效分析  

Clinical effectiveness of transpedicular bone implantation on thoracolumbar burst fracture

作　　者：李程[1] 张怀成 陈国斌 吴庆鸣 王太平[3] 

机构地区：[1]四川省资中县人民医院骨科 [2]四川省内江市中医院脊柱外科 [3]成都市第二人民医院骨科

出　　处：《骨科》2012年第2期88-90,99,共4页ORTHOPAEDICS

摘　　要：目的探讨在钉棒系统复位固定的基础上,经椎弓根椎体内植入诱导骨治疗胸腰椎爆裂性骨折的临床效果。方法 2008年2月～2010年10月收治胸腰椎爆裂性骨折并获得随访的病例58例,分A、B两组进行对比分析,每组29例。A组只作短节段钉棒系统复位固定、未植骨;B组在短节段钉棒系统复位固定的基础上,经椎弓根植入诱导骨8～10 g于爆裂性骨折椎体内。术后定期作X线片及CT片复查随访,随访12～25个月(平均17个月),将两组患者末次随访时椎体高度的丢失、骨折愈合及钉棒断裂情况进行对比分析。结果两组患者无一例伤口感染。术后及随访的X线片及CT片比较,A组手术后断钉,棒3例(均为骨不愈合,10.3%),骨折椎体空洞改变4例,1年后椎体高度均有不同程度的丢失;B组无诱导骨排斥反应、钉棒断裂病例,均骨性愈合,椎体高度丢失较轻。结论经椎弓根椎体内一期植骨,可以减少爆裂性骨折椎体不愈合,椎体高度丢失和钉棒断裂的发生。Objective To investigate the clinical effectiveness of posterior fixation combined with transpedicular bone implantation in treatment of thoracolumbar burst fractures.Methods Between Feb.2008 and Oct.2010,a total of 58 cases of thoracolumbar burst fractures treated by posterior fixation were treated and followed up.In group A,the patients were subjected to posterior fixation only（n=29）,and in group B,the patients received posterior fixation combined with transpedicular bone implantation（n=29）.A retrospective review of charts was performed.The VBs height and the rate of bone union were analyzed.Results There was no wound infection in both two groups.During the follow-up period,the curative effectiveness in group B was more satisfactory than in group A.Conclusion Posterior fixation combined with transpedicular bone implantation can reduce the recurrence of non-union and loss of VBs height of fractured VBs.

关 键 词：脊柱 骨折 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]