伤椎置钉并椎体内植骨内固定术在胸腰椎骨折治疗中的应用  

Treatment of thoracolumbar fractures with vertebral body bone graft through pedicle and transpedicular fixation via fractured vertebra

作　　者：秦入结[1] 宋波[1] 李垠[1] 盛路新[1] 刘建[1] 孙晓[1] 

机构地区：[1]徐州医学院附属连云港医院,江苏连云港222002

出　　处：《山东医药》2012年第30期22-24,共3页Shandong Medical Journal

基　　金：江苏省连云港市科技局资助课题(SH1005)

摘　　要：目的观察伤椎置钉并椎体内植骨内固定术在胸腰椎骨折治疗中的应用效果。方法至少一侧椎弓根完整的胸腰椎骨折26例,予伤椎撬拨复位置钉、椎体内植骨、椎弓根内固定,据胸腰段正侧位片比较术前、术后即刻、术后6个月的椎体高度及Cobb's角,并评估脊髓神经功能和融合情况。结果术后随访7～28个月。患者术后即刻伤椎椎体前缘高度占正常高度百分比及Cobb's角优于术前(P均<0.05);伤椎外形恢复满意;按ASIA脊髓神经功能分级,伴神经损伤者15例中,A级1例无恢复,余均改善1～3级(P均<0.05),内固定无失效,植骨皆融合。结论伤椎置钉并椎体内植骨内固定术治疗胸腰椎骨折可重建椎体结构,增强脊柱稳定,近期疗效较好。Objective To observe the outcome of vertebral body bone grafting throughpedicle combined with transpedicular fixation via fractured vertebra in the treatment of thoracolumbar fractures, and explore the operation methods, neth- otis 26 cases of thoracolumbar fractures, which had at least one side pedicle complete , were treated with posterior pedicle fixation by leverage, bone graft through pedicle and transpedicular fixation via fractured vertebra. According to the data of thoracolumbar radiograph, the anterior vertebral height and Cobb＇s angle of preoperation, postoperation instantly and after 6 monthswere compared. Their fusion results and neurological functions were observed. Results The follow-up period was 7 to 28 months . There were significant differences in the percentage of anterior vertebral height to the normal and Cobb＇s an- gle between preoperation and postoperation instantly （ all P 〈 0.05 ）. The shape of injured vertebra were restored satisfacto- rily. The spinal cord function was classified by ASIA＇s scale, it was improved 1 to 3 degree in all cases（ 15 cases） of pre- operative neurological injury except of one case of grade A （all P 〈 0.05 ）. There was no case of fixation failure, and all cases achieved bone fusion at the last follow-up time. Conclusion Posterior pedicle fixation with vertebral body bone graft and transpediculai fixation via fractured vertebra can reconstruct vertebral column efficiently, enhance the vertebral stability in the treatment of thoracolumbar fractures, and it shows satisfactory short-term effect.

关 键 词：脊柱骨折 骨折固定术 植骨 

分 类 号：R683.1[医药卫生—骨科学]