经椎弓根人工骨植骨加内固定术治疗26例胸腰椎爆裂性骨折

Treatment of 26 cases of thoracolumbar burst fractures by inter fixation with transpedicular bone grafting and simplicity inter fixation

[背景]探讨经椎弓根椎体内人工骨植骨加内固定术治疗胸腰椎爆裂性骨折的效果.[病例报告]选择26例胸腰椎爆裂性骨折病例,给予经椎弓根椎体内人工骨植骨加内固定术治疗作为观察组,与同期29例经单纯内固定治疗的同类骨折病例作为对照组观察疗效.观察组患者术后平均随访16个月,2例Cobb角加大2°,1例出现内固定物松动;对照组患者术后平均随访14个月,22例患者椎体前缘高度较术后3 d时下降6-8 mm,Cobb角加大7°-9°,10例出现内固定物松动,3例出现断钉.观察组患者伤椎前后缘高度、Cobb角的改变、螺钉松动及断钉情况等均明显优于对照组.[讨论]经椎弓根椎体内人工骨植骨术可恢复伤椎椎体正常的骨小梁结构,恢复伤椎的生物力学强度,降低后期内固定松动、断裂及矫正度丢失的发生率.

BACKGROUND To study the effects of trnspedicular bone grafting in the treatment of thoracolumbar burst fractures.CASE REPORTS26 cases of thoracolumbar burst fractures were treated by inter fixation with transpedicular bone grafting and 29 cases were treated only by internal fixation,and the curative effects were comparatively observed.The treatment group was followed up 16 months in average,and it was found that the Cobb angle increased over 2°in 2 cases and the screw of internal fixation loosed in 1 cases.The control group was followed up 14 months in average,and it was found that the height of vertebral body anterior border descended 6～8mm after operation 3 days and the Cobb angle increased over 7°～9° in 22 cases,the screws of internal fixation loosed in 10 cases and the screws were broken in 3 cases.The status of height of vertebral body anterior border,Cobb angle change,breaking and loosening of nails were better in treatment group than in control group.DISCUSSIONInternal fixation with transpedicular bone grafting can recuperate the normal bone construction and biomechanics intensity of injured centrum vertebrae,and reduce the incidence of internal fixation loosening,breaking and missing of corrective degree.