经伤椎椎弓根椎体内植骨置钉内固定治疗下腰椎爆裂性骨折

Surgical treatment of lower lumbar bust fractures with grafting in fractured vertebrae and pedicle screw fixation

目的探讨经伤椎椎弓根椎体内植骨置钉内固定治疗下腰椎爆裂性骨折的临床疗效。方法采用后路椎弓根螺钉系统复位加椎管间接减压并经伤椎椎弓根植骨置钉植骨内固定治疗下腰椎爆裂性骨折13例。结果经7～55个月随访,平均33个月。术后伤椎椎体高度恢复90%以上,椎管狭窄症状明显改善。复查X线片未见复位的椎体高度丢失。复位后的椎体高度无丢失,无明显后凸畸形,Frankel分级获得1～3级以上改善。结论下腰椎爆裂性骨折严重影响脊柱的稳定性,需积极手术治疗,经伤椎椎弓根椎体内植骨置钉内固定治疗下腰椎爆裂性骨折,可有效重建脊柱的稳定性,改善神经功能。

Objective To investigate the clinical effect of the surgical treatment of lower lumbar bust fractures with grafting in fractured vertebrae and pedicle screw fixation.Methods 13 patients with lower lumbar bust fractures received posterior pedicle screw internal fixation or and indirect decompression and grafting in fractured vertebrae and pedicle screw fixation.Results The height of fracture vertebra was reducted） 90% and had hardly loss without kyphosis 7 months to 55 months followed-up.The spinal candal stenosis was notably improved.Nervous function had improved by one three grades according to Frankel＇sgrading.Conclusion The patients with lower lumbar bust fractures had severe unstability in his thoracolumbar vertebra,the surgical treatment of lower lumbar bust fractures with grafting in fractured vertebrae and pedicle screw fixation is needed which can reconstruct the spinal stability and improve nervous function effectively.