GSS固定结合椎体增强术治疗青壮年胸腰椎压缩骨折

Clinic effects of the GSS fixation combined with vertebral body reinforcement on young patients with thoracolumbar vertebral compress fracture

目的：评价通用型脊柱内固定系统（General spine system，GSS）固定结合经椎弓根植骨椎体增强术治疗青壮年胸腰椎椎体新鲜压缩性骨折的临床疗效。方法：回顾性分析2004年1月-2007年1月，我院开展的153例GSS复位内固定治疗青壮年胸腰椎压缩性骨折的临床资料。手术前随机选择分别进行①单纯GSS固定（A组，28例），②GSS固定加横突间植骨术（B组，59例），（3）GSS固定加经椎弓根植骨椎体增强术（C组，66例）。比较手术前、后椎体后凸畸形Cobb角、椎体前缘高度变化及内固定取出后脊柱运动范围变化。结果：三组病例术后在椎体高度恢复、后凸畸形Cobb角矫正等方面明显优于手术前，差别有显著性意义（P〈0．01）；内固定取出后C组的脊柱运动范围明显优于其它两组（P〈0．05）。结论：GSS固定结合经椎弓根植骨椎体增强术能有效恢复椎体高度，矫正后凸畸形，并对脊柱运动单元影响小。

Objective： To evaluate clinic effects of General spine system （GSS） fixation combined with vertebral body reinforcement on young patients with thoracolumbar vertebral compress fracture. Methods：From January 2004 to January 2007, 153 young cases of thoracolumbar vertebral compress fracture were included in this study. Patients were treated with GSS fixation （Group A, 28 cases）, GSS fixation combined with transverse process bone grafting （Group B, 59 cases）, and GSS fixation combined with vertebral body reinforcement by transpedicular bone grafting （Group C, 66 cases） respectively. The changes of the height of vertebral body, the Cobb angle, the height of anterior edge of vertebral body, and the range of movement were measured and compared preoperatively and postoperatively （18 months after operation）. Results-For every group, the height of the vertebral body and the Cobb angle were corrected finely after the operations. The range of movement for cases of group C was superior to that of another groups after taking out of internal fixation devices （P〈0.05）. Conclusions： The GSS fixation combined with vertebral body reinforcement is a reliable method for recovering the height of vertebral body, correcting the deformation of vertebral column, and having no influence on the functional spinal unit.