经伤椎椎弓根磷酸钙人工骨植入及置钉治疗老年胸腰椎骨折  

Combination treatment of posterior pedicle screw fixation with transpedicular calcium phosphate bone grafting for elderly thoracolumbar fractures

作　　者：李浩[1] 徐建广[1] 连小峰[1] 刘小康[1] 赵成[1] 邱满乐[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《国际骨科学杂志》2014年第2期114-115,119,共3页International Journal of Orthopaedics

摘　　要：目的探讨经伤椎椎弓根磷酸钙人工骨植入及置钉手术方法治疗老年胸腰椎骨折的疗效。方法回顾性研究老年胸腰椎骨折患者56例，其中男性31例，女性25例，平均年龄65．7岁；均接受经伤椎椎弓根磷酸钙人工骨植入及置钉治疗，12个月后取出内固定。记录评估患者术前及术后椎体压缩程度、Cobb角、疼痛视觉模拟评分（VAS）。结果46例随访18～42个月，平均26个月；7例随访12个月时尚未取出内固定；3例失随访。术后患者椎体压缩程度、Cobb角、VAS评分较术前有明显改善（P〈0．05）。术后无一例患者发生椎间隙过度撑开及内固定松动或断裂。内固定取出后无椎体高度丢失发生。结论经伤椎椎弓根磷酸钙人工骨植入及置钉治疗老年胸腰椎骨折是安全有效的，可使伤椎获得良好复位与固定，有利于维持矫正效果、减少内固定松动或断裂。Objective To evaluate the efficacy of posterior pedicle screw fixation combined with transpedicular calcium phosphate bone grafting in treatment of elderly thoracolumbar fractures. Methods From January 2010 to December 2011, 56 cases of elderly thoracolumbar fracture, including 31 males and 25 females, with an average of 65.7 years old, were operated by pedicle screw fixation with transpedicular bone grafting. The internal fixation needed to be removed 12 months after the first surgery. The percentage of vertebral compression, Cobb angle of the injured vertebral segment and visual analogue scale （VAS） were assessed preoperatively and postoperatively. Results Forty six cases were folk）wed up from 18 to 42 months with an average of 26 monlhs, 7 cases had not yel removed the internal fixation when followed up at 12 months, 3 cases were lost to follow up. Compared with the preoperative, the postoperative degree of vertebral compression, Cobb angle, VAS scores were improved significantly （P〈0. 05）. None of the patients had postoperative intervertebral disc excessive open, internal fixation loosening or breakage. After internal fixations were removed, there was no vertebral height loss. Conclusions The combination treatment of posterior pedicle screw fixation with transpedicular calcium phosphate bone grafting is a safe and effective surgical technique in reducing and fixing the injured vertebral body, maintaining a good correction effect, reducing internal fixation loosening or breakage for the elderly thoracolumbar fracture.

关 键 词：胸腰椎骨折 内固定 伤椎置钉 经椎弓根植骨 

分 类 号：R687.3[医药卫生—骨科学]