经椎弓根植骨内固定治疗新鲜胸腰椎爆裂骨折的临床研究

Clinical study of transpedicular bone graft and short-segment transpedicular fixation in the treatment of thoracolumbar burst fracture

目的探讨经椎弓根植骨内固定治疗胸腰椎爆裂骨折的临床效果。方法采用经椎弓根植骨结合短节段椎弓根螺钉内固定系统治疗新鲜胸腰椎爆裂骨折42例。分别于术前和术后进行CR和CT检查，并测量伤椎椎体前缘高度和Cobb’角，比较植骨后椎体高度的恢复度和Cobb’角的纠正度。结果所有病例术后椎体高度和Cobb’角均纠正良好，随访观察平均时间14．5个月，未出现神经血管并发症，且椎体高度和Cobb’角维持满意，CT显示椎体内植骨融合良好。结论经椎弓根植骨内固定治疗新鲜胸腰椎爆裂骨折对恢复和维持伤椎高度和Cobb’角具有良好临床效果。

Objective To evaluate the efficacy of transpedicular bone graft combined with short-segment fixation in the treatment of thoracolumbar burst fracture. Methods 42 patients with new thoracolumbar burst fractore were treated using transpedicular bone graft with short-segment transpedicular fixation. All patients were examined preoperatively and postoperatively by CR and CT,and the anterior body height of injured vertebrae and Cobb＇ angle were measured and recovery degree of anterior body height after transpedicular bone graft and the rectificated dimension of Cobb＇angle were observed. Results All of the anterior body height and Cobb＇angle were well reetificated postoperatively. During the average 14.5-month of follow-up period, no complication of nerves and blood vessels was observed. The follow-up anterior body height and Cobb＇angle were satisfying and CT outcomes revealed that the transpedicular bone graft healed up well. Conclusion Transpedicular bone graft is an alternative method for in the treatment of thoracolumbar burst fractures, which is beneficial to prevent vertebrae body from collapse and to sustain Cobb＇angle postoperatively.