终板骨折对胸腰椎骨折预后的影响

Impact of endplate facture on prognosis of thoracolumbar fracture

[目的]观察终板骨折对胸腰椎骨折预后的影响。[方法]经椎弓根植骨结合椎弓根螺钉系统内固定治疗胸腰椎骨折73例,选取符合纳入标准的34例纳入观察范围。根据终板破坏程度分为A、B两组。A组:终板无骨折或仅有裂缝骨折而无爆裂,共15例;B组:终板爆裂骨折,共19例。测量手术前、后及最终随访时(平均28.6个月)的Cobb角及伤椎高度,进行统计学分析。[结果]术前A、B组的Cobb角和伤椎平均高度无统计学意义。术后A、B组的伤椎平均高度有统计学意义,B组伤椎平均高度低于A组;术后A、B组的Cobb角无统计学意义。最终随访时A、B组的Cobb角及伤椎平均高度有统计学意义,B组伤椎平均高度低于A组,B组Cobb角大于A组。[结论]终板爆裂骨折影响伤椎的复位,使伤椎高度不能很好恢复,术后逐渐出现椎体高度和矫正角度的丢失。

[Objective]To investigate the impact of endplate facture on prognosis of thoracolumbar fracture.[Method]Seventy-three patients with thoracolumbar fractures were treated with transpedicular bone grafting combined with pedicle screw fixation system.Of them,thirty-four cases eligible for the study were divided into groups A and B.Group A：no endplate fracture or minor endplate fracture.Group B：bursting endplate fracture.The height of fractured vertebra and the Cobb angle before and after operation,and at the final follow-up were determined and analysed.[Result]There were no significant differences in Cobb angles and height between growps A and B before operation.After operation,the height of fractured vertebra in group B were lower than that of group A.The Cobb angles had no significant difference between the two groups.The height and Cobb angles between the two groups had significant difference at final follow-up.The improvement in group A was significant higher than in group B.[Conclusion]Endplate bursting facture affects the reduction of fractured vertebra and causes loss of the vertebral height and the corrected angle.