【摘要】 目的探讨经伤椎椎弓根椎体内植骨结合短节段钉棒系统内固定治疗胸腰椎爆裂性骨折的临床疗效。方法选取本院2009年10月～2011年4月收治的胸腰椎爆裂性骨折患者34例,采用经伤椎椎弓根椎体内植骨结合短节段钉棒系统内固定治疗,比较患者治疗前后的临床指标并进行Frankel分级评定。结果患者手术时间为(127.6±14.8)min,术中出血量为(457.9±103.4)mL,术后24h伤口引流量为(264.3±47.2)mL,骨折愈合时间为(15.0±3.6)周。随访1年后,发生感染2例,断钉1例,脊柱曲度异常改变1例,并发症发生率为11.8%。患者术后伤椎前缘高度和伤椎后缘高度均明显大于术前,患者术后Cobb角和椎管容积减少比均明显小于术前,患者术后Frankel分级评定情况明显好于术前,差异均有统计学意义(P<0.05)。结论经伤椎椎弓根椎体内植骨结合短节段钉棒系统内固定治疗胸腰椎爆裂性骨折可以有效增强患者伤椎前中柱的稳定性和抗压能力,手术创伤小且安全性高,术后并发症发生率较低,值得临床推广使用。更多还原

【Abstract】 Objective To investigate clinical efficacy on pedicle bone graft of vertebral body through injury pedicle and short segment pedicle screw rod system fixation in the treatment of thoracolumbar burst fractures. Methods Thirty four patients with thoracolumbar burst fractures were selected in the hospital from October 2009 to April 2011, who were treated with pedicle bone graft of vertebral body through injury pedicle and short segment pedicle screw rod system fixation. Clinical indicators and frankel grading evaluation were compared before and after operation. Results Operation time was (127.6±14.8) min. Amount of intraoperative bleeding was (457.9±103.4) mL. 24 h postoperative wound drainage was (264.3±47.2) mL. Fracture healing time was (15.0±3.6) weeks. After 1 year of follow-up, infection in 2 cases, broken nail in 1 case, spinal curvature change in 1 case, the complication rate was 11.8%. The vertebral height of the front edge and vertebral height of the back edge after operation were significantly larger than those before operation. The Cobb angle and spinal canal volume reduction ratio after operation were significantly less than those before operation. Frankel grading after operation was obviously better than that before operation. The differences were statistically significant (P < 0.05). Conclusion The treatment of pedicle bone graft of vertebral body through injury pedicle and short segment pedicle screw rod system fixation for thoracolumbar burst fractures can effectively enhance vertebral anterior and middle column stability and compressive capacity of patients. The operation has small trauma and high safety with low postoperative complication rate, is worthy of clinical use.更多还原