经伤椎椎弓根植骨内固定治疗胸腰段骨折

Treatment of thoracolumbar fracture with internal fixation and bone graft through pedicle of fractured vertebra

目的探讨经伤椎椎弓根植骨内固定治疗胸腰段骨折的可行性及临床疗效。方法经伤椎椎弓根植骨内固定治疗胸腰段骨折60例,受伤节段为T11～L2,术后及随访期间摄X片测量伤椎椎体成角、上下终板成角、伤椎前缘高度与正常椎体高度的比值,了解有无复位丢失以及内固定失败等并发症。结果全部病例随访12～25个月,平均16.3个月。术中未发生置钉失败及损伤神经、血管等并发症;术后伤椎椎体成角、上下终板成角、伤椎前缘高度与正常椎体高度的比值较术前有明显改善;随访与术后相比无明显变化,未出现内固定失败。结论选择好适应证,经伤椎椎弓根植骨结合内固定是治疗胸腰段骨折的有效方法之一。

Objective To evaluate the feasibility and clinical effect of treatment of thoracolumbar fracture with internal fixation and bone graft through pedicle of fractured vertebra.Methods 60 patients with thoracolumbar fracture were treated using internal fixation and bone graft at the injured vertebra.The involved vertebrae are T11 to L2.Radiological outcomes measured after operation and during the follow-up period included the vertebral angle,the superior-inferior endplate angle and the ratio of anterior body height to the normal height.Loss of reduction and fixation failure were investigated.Results All the patients were followed up from 12 to 25 months with an average of 16.3 months.Pedicle screw failure and nerves,vascular injury did not occur during operation.The reduction effects measured by the vertebral angle,the superior-inferior endplate angle and the ratio of anterior body height to the normal height were satisfying.The correction loss was not significant and fixation failure did not occur during the follow-up period.Conclusion Internal fixation and bone graft through pedicle of fractured vertebra might be an adequate and effective procedure to be used in specific types of thoracolumbar fractures.