经椎间孔椎体间植骨融合结合伤椎椎弓根螺钉内固定治疗严重胸腰椎骨折  

Transforaminal lumbar interbody fusion combined with the injured vertebra fixation by pedicle screw for the treatment of severe thoracolumbar spine fractures

作　　者：张结合[1] 黄学应[2] 

机构地区：[1]淮南新华医疗集团新华医院骨科,安徽淮南232052 [2]安徽医科大学人体解剖教研室,安徽合肥230032

出　　处：《临床骨科杂志》2012年第3期261-263,共3页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:81171819)

摘　　要：目的探讨经椎间孔椎体间植骨融合结合伤椎椎弓根螺钉内固定治疗严重胸腰椎骨折的临床疗效。方法对15例严重胸腰椎骨折患者经椎间孔椎体间植骨、伤椎椎弓根螺钉内固定治疗,术后进行临床和影像学随访。结果 15例均获得随访,时间6～12个月。患者骨折椎体高度均明显恢复,伤椎椎体高度比:术前为49.2%±15.7%,术后3 d及3个月分别为99.2%±4.5%、91.1%±5.8%,与术前比较差异均有统计学意义(P<0.05)。Cobb角:术前为32.3°±9.6°,术后3 d和术后3个月分别为3.5°±3.4°、3.9°±3.7°,与术前比较差异均有统计学意义(P<0.05)。神经功能按ASIA分级,除5例A级患者无恢复外,其余较术前均有1级或1级以上的恢复。结论经椎间孔椎体间植骨融合结合伤椎椎弓根螺钉内固定是治疗严重胸腰椎骨折的良好方法。Objective To investigate the transforaminal lumbar interbody fusion combined with the injured vertebra fixation by pedicle screw for the treatment of severe thoracolumbar spine fracture. Methods 15 cases of severe thoracic and lumbar spine fractures were treated with intmwertebral foramen intervertebral bone and vertebral pedicle screw fixation. All patients were followed up by clinica] and imaging methods after operation. Results 15 cases were followed up for 6 - 12 months, the height of fractured vertebral restored obviously, the height ratio of vertebral body after and before surgery were 49.2% ± 15.7% , 3 days after the operation were 99, 2% ±4.5% , 3 months after the operation were 91.1% ±5.8% , compared with the preoporation, there was a significant difference（P 〈0. 05） ; the mean Cobb angle was corrected from 32. 3°± 9.6° （ before the operation） to 3.5°± 3.4° （3 days after the operation） , 3.9° ± 3.7°（3 months after the operation） ; the differences were statistically significant （P 〈 0. 05 ）. At least 1 grade of ASIA scale of neurological function improvement was got in all cases except in the 5 cases of grade 1. Conclusions Transforaminal lumbar interbody fusion combined with the injured vertebra fixation by pedicle screw for the treatment of severe thoracolumbar spine fractures is an ideal operation method.

关 键 词：胸椎 腰椎 脊柱骨折 骨折固定术 经椎间孔椎体间融合 椎弓根螺钉 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]