短节段椎弓根钉内固定结合骨椎体成形术治疗椎体骨折35例  

Treatment of Vertebral Body Fracture with Short Segmental Pedicle Screw Fixation combined with Vertebroplasty: a Retrospective Study of 35 Cases

作　　者：贾子超[1] 姜哓文 陈光[1] 康立星[1] 张振涛[1] 孙建亭[1] 康斌[1] JIA Zi-chao;JIANG Xiao-wen;CHEN Guang(Department of Orthopedic, Langfang City People' s Hospital of Hebai Province, Langfang (065000), China)

机构地区：[1]河北省廊坊市人民医院骨科,廊坊065000

出　　处：《中国中西医结合外科杂志》2018年第6期714-718,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察短节段椎弓根钉内固定结合人工骨粉骨椎体成形术治疗新鲜椎体压缩性骨折的效果。方法:收集新鲜椎体压缩性骨折患者70例,按随机数字表法分为观察组与对照组各35例,对照组给予单纯短节段椎弓根钉内固定术治疗,观察组在此基础上结合人工骨粉骨椎体成形术治疗,观察并对比两组治疗效果。结果:术后3个月,观察组脊柱后凸Cobb角[(2.81±1.25)°vs(22.08±2.94)]、伤椎前缘压缩率[(5.72±2.50)%vs (7.94±3.10)%]、伤椎后缘压缩率[(2.72±1.90)%vs (4.61±2.08)%]以及VAS评分[(2.20±0.57) vs (3.94±0.65)]均明显低于术前(P<0.05),观察组降低幅度明显大于对照组(P<0.05),观察组治疗半年后Frankel脊髓损伤功能提高III级(5例)、Ⅱ级(16例)的例数明显优于对照组(分别是0、8例, P<0.05)。结论:短节段椎弓根钉内固定结合人工骨粉骨椎体成形术治疗新鲜椎体压缩性骨折,椎体高度恢复良好、脊柱后凸畸形纠正快、疼痛少、神经功能恢复理想。Objective To observe the clinical effect of short segment pedicle screw fixation combined with artificial bone powder bone vertebroplasty in the treatment of fresh vertebral compression fractures.Methods Seventy patients with fresh vertebral compression fractures were randomly divided into observation group and control group according to random number table method,35cases in each group.The patients in control group were treated with simple short segment pedicle screw fixation,and the patients in observation group were treated with short segment pedicle screw fixation combined with artificial bone powder bone vertebroplasty.Results There were significant differences in postoperative Cobb angle[(2.81±1.25)°vs(22.08±2.94)°],anteroposterior vertebral compression rate[(5.72±2.50)%vs(7.94±3.10)%],posterior margin compression rate[(2.72±1.90)%vs(4.61±2.08)%]and VAS score(2.20±0.57vs3.94±0.65),compared with pre-operation on the third month after operation(P<0.05);the reduced range of the observation group was significantly higher than that of the control group(P<0.05).After half a year of treatment,Frankel’s spinal cord injury function was improved in grade III(5cases)and grade II(16cases)in the observation group,which were significantly better than those in the control group(0and8cases,respectively,P<0.05).Conclusion In the treatment of fresh vertebral compression fractures,the method of short segment pedicle screw fixation combined with artificial bone powder bone resection is effective,which can effectively restore vertebral height in the short term,correct kyphosis,reduce pain,and promote nerve function recovery,with a high promotional value.

关 键 词：短节段椎弓根钉内固定术 人工骨粉 骨椎体成形术 椎体压缩性骨折 

分 类 号：R683.2[医药卫生—骨科学]