后路内固定加经伤椎椎弓根植骨治疗胸腰椎骨折

Posterior internal fixation with transpedicular artificial bone graft for thoracolumbar fracture treatment

目的探讨后路椎弓根螺钉复位固定加经伤椎椎弓根人工骨植骨术治疗胸腰椎骨折的方法与疗效。方法2004年8月—2008年2月应用后路内固定经伤椎椎弓根人工骨植骨术治疗胸腰椎骨折56例，T113例，T1221例，L123例，L29例。结果56例病例均得到随访。随访时间12-36个月（平均19个月）。术前椎管占位25%-75%（平均37%），椎体压缩40%-70%（平均56%），cobb角21.5°-42.3°（平均29°）。术后椎管内占位5%-20%（平均13.6%），椎体高度65%-98%（平均82.5%），cobb角3.1°-9.3°（平均5.6°）。长期随访术后cobb角丢失〈1°，椎体前缘高度丢失〈2 mm。结论后路内固定结合经伤椎椎弓根人工骨植骨术是治疗胸腰椎骨折有效方法，与单纯前、后路内固定手术相比具有一定的优势。

Objective To assess the outcomes of posterior fixation with transpedicular artificial bone graft for thoracolumbar fracture treatment. Methods Fifty-six patients with thoracolumbar fracture underwent posterior fixation with transpedicular artificial bone graft surgeries from August 2004 to February 2008, among these cases three were at T11, 21 at T12, 23 at L1, nine at L2. Results All the patients received follow-up visits and the average follow-up period was 19 months （12 - 36 months）. Before operation, the average canal compromise was 37% （25% -75% ）, average vertebrae compression was 56% （40% - 70% ）, and average cobb＇ s angle was 29° （21.5°-42.3°）. After operation, the average canal compromise was 13.6% （5% - 20% ）, average height of vertebrae was 82.5 % （65 % - 98 % ）, and average cobb＇ s angle was 5.6° （3.1°- 9.3°）. In follow- ups, the average cobb＇ s angle loss was 〈 1° while average height of vertebrae loss in anterior border was 〈 2 mm. Conclusion Posterior intemal fixation with transpedicular artificial bone graft is an effective method in the treatment of thoracolumbar fracture with a superior result to those of sole anterior or posterior fixation.