后路短节段内固定经椎弓根液态人工骨植骨治疗胸腰椎骨折的临床应用研究  

Short-segment transpedicular screw internal fixation combined with artificial bone implantation in treatment of thoracolumbar fracture

作　　者：陈欢欢[1] 邢进峰[1] 丁伟航[1] 汤小康[2] 

机构地区：[1]浙江中医药大学附属第一医院骨伤科,杭州310006 [2]湖南中医药大学附属第一医院骨伤科

出　　处：《浙江医学》2015年第6期451-453,521,共4页Zhejiang Medical Journal

摘　　要：目的 分析胸腰椎骨折后路复位短节段内固定经椎弓根Wright液态人工骨植骨的疗效.方法 38例胸腰椎骨折患者结合患者的经济能力分为两组,A（未植骨）组24例单纯行后路切复椎弓根螺钉内固定术,B（植骨）组14例一期行后路切复椎弓根螺钉内固定并经椎弓根行椎体内Wright液态人工骨植骨术,分别随访10～27个月,比较两组患者拆钉时伤椎前缘高度的再压缩率、Cobb角变化及伤椎影像学的变化.结果 B组患者拆钉时伤椎前缘高度再压缩率为（5.43±2.71）％,术后Cobb角增大为（2.03±0.51）°,与A组（6.29±2.24）°相比差异有统计学意义（P＜0.05）,A组患者术后不同程度的出现蛋壳样改变,其中2例出现断钉,1例患者出现上位椎弓根钉切割出椎体,而B组患者未出现明显蛋壳样改变及断钉现象.结论 胸腰椎骨折后路复位短节段椎弓根钉内固定经椎弓根Wright液态人工骨植骨能明显改善伤椎骨折的愈合,维持椎体的高度,减少蛋壳样改变及断钉等情况的发生.Objective To evaluate the efficacy of short-segment transpedicular screw internal fixation combined with implantation of liquid artificial bone in treatment of thoracolumbar fracture. Methods Thirty eight patients with thoracolumbar fracture were included in the study, including 24 cases treated by short-segment transpedicular screw internal fixation （group A）, 14 cases treated by short-segment transpedicular screw internal fixation combined with transpedicular implantation of liquid artificial bone （group B）. Patients were followed up for 10-27 month, the changes of anterior height of the fractured vertebra, Cobb＇s angle and imaging changes were compared between two groups. Results When the fixation were removed, the change of anterior height of the fracture vertebral in group B was （5.43 ± 2.71）%, the change of the Cobb＇s angle was （2.03 ± 0.51）°, which were significantly different to those in group A （P〈0.05）. Two patients in group A had broken transpedicular screws, but no such complications occurred in group B. Conclusion Short-segment transpedicular screw internal fixation combined with implantation of liquid artificial bone is more effective than fixation alone in treatment of patients with thoracolum- bar fracture.

关 键 词：胸腰椎 脊柱骨折 椎弓根螺钉 液态人工骨 

分 类 号：R687.3[医药卫生—骨科学]