短节段椎弓根钉内固定结合伤椎内植骨术治疗新鲜胸腰椎骨折  

Short segments using pedicle screws injury in the vertebral bone graft with surgical treatment fresh thoracolumbar fractures

作　　者：付涛[1] 王国选[1] 杨民[1] 

机构地区：[1]新疆生产建设兵团医院创伤骨科,新疆乌鲁木齐830002

出　　处：《生物骨科材料与临床研究》2012年第4期60-61,64,共3页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：新疆生产建设兵团科技立项计划(2010GG52)

摘　　要：目的探讨短节段椎弓根钉内固定结合伤椎内植骨术治疗新鲜胸腰椎骨折的临床应用及疗效。方法采用后路短节段椎弓根钉系统复位固定并经伤椎椎弓根椎体内植骨术治疗新鲜胸腰椎骨折35例,分别于术前、术后及随访时测量伤椎前、后缘高度和Cobb角,比较植骨后推体高度的恢复度和Cobb角的纠正度。结果本组病例均获随访,平均随访时间12.5个月。平均骨折愈合时间5.4个月。全部随访患者未出现断钉、断棒及椎弓根钉拔出。所有病例术后及随访时椎体高度和Cobb角均纠正良好,脊柱椎体排列良好,椎体内植骨融合良好。其中11例1年后,10例1年半后取内固定物,取内固定物半年后拍片未见椎体高度丢失和塌陷。结论后路短节段椎弓根钉内固定结合伤椎内植骨术治疗新鲜胸腰椎骨折治疗能不仅有效恢复伤椎高度,尽早形成伤椎的骨性愈合,增加伤椎前、中柱的支撑力,重建了伤椎前、中柱的稳定性,而且保留伤椎邻近节段的运动单元功能,恢复脊柱的生理功能,有效防止断钉、内固定物松动、椎体前缘高度丢失、Cobb角变大、继发腰椎不稳、临近节段间盘退变以及椎管狭窄等并发症的发生。Objective To study the short segment pedicle screw fixation, combined with the clinical application and ef- ficacy of fresh bone graft in the treatment ofthoracolumbar fractures in the fractured vertebral body. Methods Reduction and fixation of posterior short segment pedicle screw system and the injury pedicle vertebral bone graft in the treatment of fresh thoracolumbar fractures in 35 cases, preoperative, postoperative, and follow-up measurements of fractured vertebral body, posterior margin height and Cobb angle to compare the bone graft height to push the body to restore, and Cobb angle correction degree. Results All cases were followed for an average time of 12.5 months. Theaverage fracture healing time was 5.4 months. All follow-up patients had no broken nails, broken rods and pedicle screw pull out. All cases of postoperative and follow-up of vertebral height and Cobb angle corrected spinal vertebrae arranged, and fusion in the ver- tebral body. 11 cases a year and 10 cases a year and a half after take fixation fixture for six months after the film take no vertebral height loss and collapse. Conclusion Posterior short segment pedicle screw fixation combined with the fractured vertebral bone graft treatment of fresh thoracic vertebral fracture treatment can not only effectively restore the fractured vertebral body height, as soon as possible the formation of the fractured vertebral bone healing, increase fractured vertebral column support force and rebuild the fractured vertebral column stability, and to retain the fractured vertebral body adjacent segments of the motor unit function to restore the physiological function of the spine, effectively preventing broken nails, loose fixation, anterior vertebral height is lost, the Cobb angle becomes larger, secondary to lumbar instability, adjacent level disc degeneration and spinal stenosis, the incidence of complications.

关 键 词：胸腰椎骨折 椎弓根植骨 短节段椎弓根钉内固定 

分 类 号：R687.3[医药卫生—骨科学]