后路椎弓根植骨结合椎弓根钉系统治疗胸腰椎骨折

Pedicle bone grafting with posterior pedicle screw system on thoracolumbar vertebral fractures

目的探讨后路椎弓根植骨结合椎弓根钉系统治疗胸腰椎骨折的方法和效果。方法62例胸腰椎骨折患者，在均采用椎弓根钉系统治疗的同时，用自制植骨推注器经椎弓根椎体内植骨结合中后路植骨治疗，术后卧床15～20d，并进行康复背肌锻炼，腰围保护3—6个月。结果本组62例患者手术均获得成功，优良率为83．87％，术后椎体高度及生理弧度恢复满意，未出现神经症状加重，经随访6～28个月，椎体高度和生理弧度无明显丢失，无断钉、断杆、内固定松动、椎体再压缩等并发症。结论AF椎弓根系统对胸腰椎骨折具有良好的复位和固定作用，经椎弓根椎体内植骨在后路手术不加大创伤的同时，能即时增加椎体的骨容量和脊柱前柱的抗压稳定性，使患者能早期活动，减少内固定物因应力过大造成的断钉、断杆，椎体再压缩等并发症。

Objective To explore the methods and results of the combination of posterior pedicle graft and pedicle screw system for treatment of thoracolumbar fractures. Methods Sixty - two cases of thoracolumbar fracture patients were treated with pedicle screw system, at the same time, push the injection device with self- made bone graft within the vertebral body through the pediele bone graft with posterior bone graft in the treatment of bed rest after 15 to 20 days and carryed out rehabilitation exercises back muscles, waist to protect 3 to 6 months. Results Sixty - two patients in this group were operated successfully, the fine rate was 83.87% , postoperative physiological curvature of vertebral height and satisfactory recovery without neurological symptoms have increased by 6 to 28 months follow - up of vertebral height and no obvious physiological radian lost. No broken nail, broken rod fixation loosening or vertebral compression again. Conclusions AF pedicle screw system for thoracolumbar fractures with good reduction and fixation, by pediele bone graft in the posterior vertebral body does not increase the surgical trauma, it is able to immediately increase the capacity of vertebral bone and spine stability of anterior column in compression, so that patients can be an early activity and reduce broken nails, broken rod, complications such as vertebral compression again due to too much stress.