后路椎弓根内固定治疗胸腰段骨折不同植骨方法临床疗效比较

Clinical Efficacy Comparison of Different Bone Grafting Pattern Combined with Pedicle Screw Fixation for the Treatment of Thoracolumbar Fractures

为了比较后路椎弓根螺钉复位内固定治疗胸腰段骨折不同植骨方法的临床疗效,2002年1月-2006年9月,经后路椎弓根螺钉复位内固定手术治疗胸腰段骨折140例。比较分析各组伤椎高度矫正丢失,脊柱后凸成角矫正丢失,脊髓神经功能恢复,内固定失效及腰背疼痛并发症情况。结果显示,伤椎前、后缘高度比值和脊柱后凸成角术前4组差异不具有显著性意义,椎弓根螺钉复位内固定结合不同植骨融合方法,可以减少单纯内固定矫正丢失和内固定失效及腰背疼痛并发症。经椎弓根椎体内植骨可增加前中柱的稳定性,临床治疗优于脊柱后方植骨融合。

To compare the clinical efficacy of different bone grafting pattern combined with pedicle screw fixation for the treatment of thoracolumbar fractures. 140 patients with thoracolumbar fractures were treated surgically through posterior approach with pedicle screw fixation. The outcomes were analyzed and compared in terms of the loss of correction of vertebral height, the loss of correction of kyphosis, the recovery of neurologic deficit, the failure of instrumentation and the complication of low back pain. There were no significant statistical differences for preoperative vertebral height and kyphosis in all four groups. Pedicle screw fixation combined with different bone grafting pattern for the treatment of thoracolumbar fractures could decrease the loss of correction and the failure of instrumentation and the complication of low back pain than instrumentation only. The pattern of transpedicular intrabody bone grafting may effectively improve the stability of the anterior and median volume of the spine and give rise to superior outcomes than posterior bone grafting.