后路椎弓根固定加椎间植骨治疗胸腰椎爆裂骨折

Treatment of thoracolumbar burst fractures with posterior pedicle fixation and interbody bone grafting

目的探讨后路椎弓根螺钉固定联合椎间植骨治疗胸腰椎爆裂骨折的疗效。方法对62例胸腰椎爆裂骨折患者采用后路减压国产通用型脊柱固定系统（general spine system，GSS）椎弓根螺钉固定联合椎间植骨融合手术，比较术前、术后相邻椎体上下终板成角（Cobb角）、椎体前缘高度与正常高度的比值、椎管骨性占位率等指标，了解术后骨折复位情况以及随访期间内固定有无失败和复位丢失情况。结果通过手术减压复位，Cobb角、椎体前缘高度与正常高度的比值、椎管骨性占位率均明显改善。术后随访测量与术后相比尤明显变化，无一例发生内固定失败。结论后路椎弓根螺钉联合椎间植骨治疗胸腰椎爆裂骨折可以有效防止内固定失败、复位丢失和后凸畸形，是治疗胸腰椎爆裂骨折较理想的方法。

Objective To investigate the curative effects of posterior pediele screw fixation plus interspinal bone grafting in treatment of thoracolumbar burst fractures. Methods The study involved 62 patients with thoracolumbar burst fractures treated with posterior pedicle screw instrumentation plus interspinal bone grafting. The Cobb angle, the ratio of anterior body height to the normal height and spinal canal blockage before and after surgery were compared for observation on postoperative fracture healing as well as internal fixation failure or reduction loss during follow-up. Results The operative decompression and reduction exerted significantly positive effect on the Cobb angle, the ratio of anterior body height to the normal height and spinal canal blockage. The follow-up showed no significant correction loss or fixation failure. Conclusions Posterior pedicle screw plus interspinal bone grafting is an ideal method for treatment of thoracolumbar burst fractures, for it can prevent failure, reduction loss and kyphotic deformity.