短节段椎弓根钉内固定结合硫酸钙人工颗粒骨椎体成形术治疗新鲜胸腰椎骨折

Transpedicular Fixation Combined with Vertebral Plasty of Pellet Artificial Bones of CaSO_4 in Treatment of New Thoracolumbar Spine Fracture

目的探讨短节段椎弓根钉复位固定结合硫酸钙人工颗粒骨椎体成形术治疗新鲜胸腰椎骨折的方法和临床意义。方法采用后路短节段椎弓根螺钉撑开复位后经单侧或双侧伤椎椎弓根向复位的椎体内植入硫酸钙人工颗粒骨35例,术后观察骨折椎体前后缘及椎体中央高度压缩率变化,Cobb角改善情况及并发症。结果术后末次随访测得椎体前、后缘及中央高度压缩率及Cobb角,与术前相比差异均有统计学意义(P<0.05);而与术后即刻相比差异无统计学意义(P>0.05)。25例脊髓神经不完全损伤患者,按美国脊髓损伤协会标准评定,术后神经功能均有1级或1级以上的恢复,骨折椎体高度恢复并维持良好,无植骨操作引起的神经血管并发症。结论后路短节段椎弓根钉复位内固定结合硫酸钙人工颗粒骨椎体成形术能恢复椎体高度及强度,改善椎体经终板塌陷的复位效果,且更安全,不会渗漏至椎管内造成严重并发症。

Objective To study the long term results of transpedicular fixation combined with vertebral plasty of pellet artifical bones of CaSO4 in treatment of new thoracolumbar spine fracture. Methods Thirty-five patients with thoracolumbar spine fracture were treated with short segmental transpedicalar fixation combined with vertebral plasty of pellrt artificial bones of CaSO4. X-ray and CT examinations were done preoperatively and at different times of follow- up. The change of compressed ratios of the anterior and posterior edge of vertebral body and the middle heights of the injured vertebra postoperatively, the improved Cobb angle were observed respectively. Results The mean value of anterior compressed ratios had statistical significane between postoperaitive period and preoperative for period. The mean value of posterior compresdsed ratio had statistical significance between preoperative period and postoperative period. The mean value of the middle heights compressed ratios had statistical significane between postoperative period and preoperative period. Further-more, the Cobb angle was improved. All patients were followed up between 24 and 36 months. Twenty-five patients with spinal cord and nerve injuries reached grade I by ASIA. Conclusion Transpedicular fixation combined with vertebral plasty of pellet artificial bones of CaSO4 can restore the vertebral endplate with high security.