后路伤椎椎弓根螺钉固定治疗胸腰椎骨折临床分析

Clinical evaluation of posterior pedicle screw instrumentation at the injured level for thoracolumbar vertebra fracture

目的分析经后路伤椎椎弓根螺钉固定治疗胸腰椎骨折的临床效果及安全性;比较经伤椎单侧及双侧椎弓根螺钉固定的差别。方法采用后路经伤椎植入椎弓根螺钉术对32例胸腰椎骨折患者进行治疗,通过比较患者术前、术后伤椎椎体压缩率的变化,评价其术后伤椎椎体复位情况。结果 32例患者术后伤椎椎体压缩得到明显改善,压缩百分比由术前平均43.7%减小到术后平均3.2%(P<0.05)。单、双侧椎弓根螺钉固定对伤椎椎体压缩改善差异无统计学意义(P>0.05)。32例患者术后均获得三月到一年随访,随访期间复查X线片显示椎体高度无丢失,内固定无松动或断裂。结论后路经伤椎椎弓根螺钉固定治疗胸腰椎骨折效果良好,安全可靠。

Aim To evaluate the security and clinical effect of reduction and fixation on thoracolumbar vertebra fracture by posterior pedicle screw instrumentation at the injured level and TO compare the results of unilateral and bilateral vertebral pedicle screw fixation at the injured level.Methods Thirty-two cases of thoracolumbar fracture were treated with posterior pedicle screw fixation at injured vertebra.The effect of operation was evaluated by variation of injured centrum compressibility.Results All 32 patients had achieved good results of reduction and fixation.The average percentage of vertebral compression changed from 43.7%（preoperative）to 3.2%（postoperative）（P〈0.05）,but no significant difference between the unilateral pedicle screw group and the bilateral pedicle screw group（P〉0.05）.All patients were followed up for 3～12 months.The X ray plates showed that there was no loss of vertebral height,no loosening or breakage of internal fixation.Conclusion Good effect and security can be achieved by pedicle screw fixation at the injured level for thoracolumbar fracture.