经伤椎椎弓根自体骨植骨联合螺钉内固定术治疗腰椎压缩性骨折78例效果观察  

Effect of transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra for treatment of lumbar vertebrae compression fractures(report of 10 cases)

作　　者：李振[1] 齐建军[1] 董明岩[1] 

机构地区：[1]辽宁医学院附属第一医院,辽宁锦州121001

出　　处：《山东医药》2012年第23期17-18,共2页Shandong Medical Journal

基　　金：辽宁省教育厅课题项目(2009A452)

摘　　要：目的探讨经伤椎椎弓根自体骨植骨联合螺钉内固定术治疗腰椎压缩性骨折的临床疗效。方法对78例腰椎压缩性骨折患者采用经伤椎椎弓根自体骨植骨联合螺钉内固定术治疗。于术前、术后1周、术后7个月对伤椎及上下椎体进行X线检查,计算伤椎前、中、后缘及伤椎高度值、伤椎Cobb's角,观察伤椎愈合恢复及并发症情况,采用Frankel分级标准评定神经功能恢复情况。结果术后1周和7个月伤椎前中后三线高度较术前均有满意恢复,Cobb's角无明显矫正丢失,无切口感染、神经症状加重、内固定松动及断裂。患者神经功能得到较好改善,不完全脊髓损伤均有1～2级神经功能改善。结论经伤椎椎弓根自体骨移植及螺钉内固定术治疗腰椎压缩性骨折临床效果确切,同时可防止骨折缺损及脊柱平背畸形等并发症的发生。Objective To explore the clinical efficacy of transpedicular intracorporeal grafting combined with pedicle screw via the injured vertebra for the treatment of lumbar vertebrae compression fractures. Methods A total of 78 patients with lumbar vertebrae compression fractures were treated with transpedicular intracorporeal grafting combined with pedicle screw via the injured vertebra. At the time before operation and 1 week, 7 months after operation, X-ray was performed for evaluating anterior, posterior and central section heights of the injured vertebra and Cobb＇s angle. Postoperative complications and neurofunctional recovery of the spinal cord were evaluated. Results One week and 7 months after surgery, anterior,posterior and central section heights of the injured vertebra showed good recovery, and the loss of Cobb＇s angle appeared small. There was no infection of incision and no aggravation of spinal cord function. There was no implant failure and no loss of spinal curvatures. In patients with incomplete injury, neurofunetions showed 1 to 2 grade improvement compared with the findings before operation. Conclusion Transpedicular intraeorporeal grafting is effective and safety to repair fractured vertebra in the vertebral body defects.

关 键 词：腰椎压缩性骨折 椎弓根 自体骨 植骨 内固定 

分 类 号：R683.2[医药卫生—骨科学]