【摘要】 目的探讨短节段经伤椎单侧置钉固定与其结合椎体内植骨治疗胸腰椎骨折的临床疗效。方法回顾性分析自2009-06—2012-06行手术治疗的胸腰椎骨折245例的相关资料。采用短节段经伤椎单侧置钉固定术131例,行短节段经伤椎单侧置钉固定结合椎体内植骨术114例,测量伤椎及其上、下相邻正常椎体的前缘、中间的高度、伤椎后凸Cobb角,比较两组的椎体压缩率、矫正度丢失、术中出血量、手术时间和患者满意度。结果术后随访18~24个月,平均21.8个月,随访期间椎体高度均无严重丢失,无钉棒弯曲、松动或断裂。伤椎椎体压缩率由术前的(45.59±5.2)%和(46.48±7.5)%降至术后的(8.76±4.8)%和(9.24±4.6)%;后凸Cobb角由术前的(25.8±3.8)°和(24.6±4.2)°降至术后的(9.8±1.7)°和(8.6±2.7)°,两者无明显变化(P>0.05)。2组伤椎中间高度由术前的(56.74±8.6)%和(55.60±7.3)%升至术后的(85.26±10.52)%和(92.52±8.4)%,差异有统计学意义(P<0.05)。结论短节段经伤椎单侧置钉固定与其结合椎体内植骨治疗胸腰椎骨折均可取得满意治疗效果。更多还原

【Abstract】 Objective To assess the clinical effect of short-segmental fractured vertebral pedicle screw unilateral fixation and bone graft through pedicle for thoracolumbar fracture. Methods From June 2009 to June 2012, 245 cases of thoracolumbar spine fracture were retrospectively analyzed. Of which, 131 patients underwent short-segmental transvertebral pedicle screw internal fixation, 114 patients underwent short-segmental transvertebral pedicle screw internal fixation and bone graft. The anterior height of the injured vertebrae and the adjacent two normal vertebrae, and the Cobb angle of the injured vertebrae were measured. The compression rate, the loss of correction, the operation time, and blood loss of the two groups were compared. Results All patients were followed up for an average of 21.8(18 to 24) months. The breakage of implants and loosing of pedicle screws did not occur. Injured vertebral compression rate of the preoperative by(45.59 ±5.2)% and(46.48±7.5)% down to postoperative(8.76 ±4.8)% and(9.24 ±4.6)%; Cobb angle preoperative by(25.8 ±3.8)° and(24.6 ±4.2)° fell to postoperative(9.8 ±1.7)° and(8.6±2.7)°, no obvious changes(P >0.05). The mid-height of the injured vertebrae preoperative(56.74±8.6)% and(55.60±7.3)% increase to postoperative(85.26±10.52)% and(92.52±8.4)%, the difference was statistically significant(P <0.05). Conclusion The clinical outcomes of short-segmental transvertebral pedicle screw unilateral internal fixation and bone graft through pedicle for unstable thoracolumbar fracture are satisfactory.更多还原