经伤椎椎弓根固定结合椎体内植骨治疗胸腰椎骨折的疗效分析

The curative effect analysis of treatment of thoracolumbar fracture with internal fixation and bone graft through pedicle of fractured vertebra

目的探讨采用后路椎弓根螺钉固定结合经伤椎椎体内植骨螺钉固定治疗胸腰椎骨折的疗效。方法选取自2004年3月～2006年10月间经后路减压横突间植骨融合椎弓根螺钉内固定治疗胸腰椎骨折患者61例作为研究对象且分为两组:(结合经伤椎椎弓根螺钉固定椎体内植骨者27例为A组,仅行后路减压横突间植骨融合椎弓根螺钉内固定者为B组)进行回顾性分析。术后随访2～2.5年,观察两组间术后2周及内固定物去除后伤椎椎体高度、Cobb角的变化;同时评价内固定的失败率。结果Cobb角及伤椎体高度在术后2周两组间比较无显著性差异(P>0.05),但在内固定去除后两组间比较有统计学意义(P<0.05);A组在内固定去除后腰背痛发生率较低且未发现内固定失败。结论经伤椎椎弓根固定结合伤椎体内植骨治疗胸腰椎骨折可以降低术后矫正角度的丢失及内固定的失败率。

Objective To explore the prostecdtive efficacy of treatment of thoracolumbar fracture with internal fixation and bone graft through pedicle of fractured vertebra. Methods Sixty-one cases with thoracolumbar fracture were analyzed retrospectively. The patients were divided into two groups. Following up 2-2.5years, to observe changes of the height of fractured vertebra and Cobb angle, evaluating the failure rate of internal fixation. Results There were no significant differences about the Cobb angle and the height of fractured vertebra between two groups postoperative two weeks. But there were significant differences after internal fixations removed. The internal fixation failure of group A was not found, and the incidence rate of lumbodorsal pain was lower. Conclusions It can degrade the loss of right angle and the failure rate of internal fixation that the treatment of thoracolumbar fracture with internal fixation and bone graft through pedicle of fractured vertebra.