短节段椎弓根螺钉固定联合后凸成形术治疗多节段非相邻型胸腰椎骨折疗效分析

Research on short-segment pedicle screw fixation and percutaneous kyphoplasty in the treatment of multi-level noncontiguous thoracolumbar fractures

目的:探讨短节段椎弓根螺钉固定联合磷酸钙骨水泥球囊后凸成形术治疗多节段非相邻型胸腰椎骨折的临床价值。方法:2007年6月～2009年6在本院就诊的多节段非相邻型胸腰椎骨折患者36例,均采用短节段椎弓根螺钉固定联合磷酸钙骨水泥球囊后凸成形术治疗,观察与评估患者手术前后的影像学测量结果、神经功能变化及术后并发症的发生情况。结果:所有患者术后1周、术后1年、术后3年的椎体压缩率(前缘、中央、后缘)、椎管侵占率及伤椎Cobb′s角度相比术前均显著性减小(P<0.05);患者术后的神经功能有所改善,ASIA分级提高一级或以上患者共31例;患者术后总并发症发生率为11.11%。无明显疼痛、无神经根加重症状等。结论:短节段椎弓根螺钉固定联合磷酸钙骨水泥球囊后凸成形术治疗多节段非相邻型胸腰椎骨折可明显降低椎体压缩率和椎管侵占率,减小伤椎Cobb′s角度,改善患者神经功能。

Objective： To investigate the clinical value of short-segment pedicle screw fixation and percutaneous kyphoplasty in the treatment of multi-level noncontiguous thoracolumbar fractures.Methods： The 36 cases of patients with multi-level noncontiguous thoracolumbar fractures admitted to hospital from June 2007 to June 2009 were treated with short-segment pedicle screw fixation and percutaneous kyphoplasty.The fluoroscopy,neurological function and the occurrence of complications were analyzed.Results： The packing ratio of vertebral body,invasion ratio of vertebral canal,and injured vertebra Cobb ＇s angle one week,one year,three years after surgery were significantly lower than preoperative status（P0.05）;the neurological function of patients after undergoing surgery was improved,ASIA of 31 cases were improved one or more grade levels;the total adverse reactions rate was 11.11%,and there was no severe pain and aggravate symptoms of nerve root.Conclusion：Short-segment pedicle screw fixation and percutaneous kyphoplasty in can reduce the packing ratio of vertebral body,invasion ratio of vertebral canal,and injured vertebra Cobb ＇s angle,and improve patients＇ neurological function in patients with multi-level noncontiguous thoracolumbar fractures