胸腰椎爆裂性骨折手术治疗中融合与非融合比较的研究  

A research report on the comparison of surgical methods of fusion and non-fusion in the treatment of thoracolumbar burst fractures

作　　者：张征石[1] 汤国庆[1] 陈吉[1] 吴天河[1] 

机构地区：[1]江苏省昆山市中医医院脊柱骨科,215300

出　　处：《中国骨与关节杂志》2012年第6期587-590,共4页Chinese Journal of Bone and Joint

摘　　要：目的评价胸腰椎爆裂性骨折后路椎弓根钉棒系统内固定术治疗中,后外侧植骨融合与非融合的临床疗效。方法 2003年2月至2010年2月收治46例胸腰段脊柱爆裂性骨折,病例随机分为两组(A组-未植骨组、B组-植骨组)进行治疗,对比术前、术后及随访时伤椎后凸畸形角(Cobb's角)、伤椎前缘高度百分比(anterior vertebral height,AVH)的变化。结果随访时间18-26个月,平均20个月。无固定失败病例。A组手术时间和出血量明显小于B组,两组手术前后和末次随访的Cobb's角、AVH相对变化差异无统计学意义。结论较轻的胸腰椎爆裂性骨折应用非融合椎弓根钉内固定与行后外侧融合的疗效相似,且手术时间、术中出血量相对较少。Objective To evaluate the clinical effects of posterolateral bone grafting for fusion and non- fusion in the posterior pedicle screw fixation for the patients with thoracolumbar burst fractures. Methods From February 2003 to February 2010, 46 patients with thoracolumbar burst fractures were adopted. The patients were randomly divided into 2 groups： group A （without grafting treatment） and group B （with grafting treatment）. The changes in Cobb＇s angle of kyphosis and percentage of anterior vertebral height （AVH） of the injured vertebra preoperatively, postoperatively and during the follow-up were compared. Results The patients were followed up for an average period of 20 months （range; 18-26 months）. No failed internal fixation was found. The operation time and blood loss were much shorter and less in group A than in group B. There was no statistically significant difference in the changes of Cobb＇s angle and AVH between the 2 groups preoperatively, postoperatively and in the latest follow-up （P〉0.05）. Conclusions The efficiency of non-fusion pedicle screw fixation is similar to that of posterolateral fusion in the treatment of light thoracolumbar burst fractures, with shorter operation time and less intraoperative blood loss.

关 键 词：胸椎 腰椎 骨折 融合 非融合 

分 类 号：R687.3[医药卫生—骨科学]