AF椎弓根固定技术治疗骨质疏松伴胸腰椎骨折脱位疗效分析

AF pedicle fixation for the treatment of thoracic and lumbar fracture with osteoporosis

目的探讨AF椎弓根固定技术治疗骨质疏松伴胸腰椎骨折脱位效果。方法回顾分析29例患者术前术后临床及影像学资料和随访结果,测量矢状指数、椎体压缩高度、后凸畸形Cobb角,评估植骨融合的远期治疗效果。结果术后随访3-48个月,骨折复位满意,椎体高度矢状径指数从伤前的41%恢复到术后的92%,未发生螺钉断裂或脱出现象。22例二次术后18个月取出内固定后随访12-36个月,椎体高度矢状径指数为91%,X线片未见后凸加重或变形,未出现再次塌陷。结论骨质疏松伴胸腰椎骨折脱位应采用综合治疗,有效的椎弓根复位固定技术、撬拨复位恢复椎体高度及充足可靠的植骨融合技术是保持良好疗效的关键。

Objective To study the effect of AF pedicle fixation for the treatment of thoracic and lumbar fracture with osteoporosis. Methods 29 cases were analyzed retrospectively, including pre- and postoperative clinical and images data, sagittal index, vertebral body height, kyphosis Cobb angle. Long term effect of bone graft fusion was evaluated. Results All cases were followed up for 3 - 48 months. All fractures got satisfactory reduction. Sagittal index of vertebral body height was restored from 41% to 92%. No screw breakage or protrusion was found. 22 cases got implants removal in 18 months, and continued to be followed up for 12 - 36 months. Sagittal index of vertebral body height was 91%. No aggravation of kypbosis, deformity or collapse was found. Conclusions Osteoporotic thoracic and lumbar fracture should be treated comprehensively. The key points are effective transpedicle reduction and fixation, prizing reduction to restore vertebral height, and sufficient bone graft and reliable fusion skills.