GSS椎弓根螺钉内固定并二期伤椎骨水泥灌注治疗胸腰椎骨折

GSS pedicle screw fixation combined with two-stage bone cement perfusion for thoracolumbar fractures

目的探讨GSS椎弓根螺钉内固定结合二期伤椎骨水泥灌注治疗胸腰椎骨折的有效性和安全性。方法2005年3月～2010年10月共31例胸腰椎爆裂性骨折患者行后路GSS椎弓根螺钉内固定治疗,术后3～18个月根据X线及CT复查情况,出现"蛋壳现象"的患者在取出内固定前行伤椎骨水泥灌注,记录术前、术后及末次随访时的伤椎高度及X线片测量的Cobb角角度。结果本组患者均未出现骨水泥渗漏,术后12～18个月取出内固定后再随访1～3年。术后伤椎椎体高度及Cobb角与术前相比有明显改善。结论 GSS椎弓根螺钉内固定结合二期伤椎骨水泥灌注治疗胸腰椎骨折可达到良好的治疗效果,可作为治疗胸腰椎骨折的新的尝试。

Objective To explore the efficacy and safety of surgical treatment of thoracolumbar fractures by GSS pedicle screw fixation combined with two-stage bone cement perfusion.Methods From March 2005 to October 2010,31 patients with thoracolumbar bursting fractures were treated with posterior GSS pedicle screw fixation.The patients were reviewed by X-ray and CT scan 3-18 months postoperatively.Once ＂eggshell phenomenon＂ appeared,bone cement was used in the injured vertebral body before removing the fixators.Injured vertebral height and Cobb＇s angle were measured preoperatively,postoperatively and at the final follow-up.Results No leakage of bone cement happened in all the patients.The internal fixators were removed 12-18 months postoperatively.Then the patients were followed up for 1-3 years.Fractured vertebral height and Cobb＇s angle were significantly improved after surgery.Conclusion GSS combined with two-stage bone cement perfusion for thoracolumbar fractures can achieve a good therapeutic effect.It can be taken as an attempt at the treatment of thoracolumbar fractures.