可吸收骨水泥联合椎弓根钉内固定治疗胸腰段脊柱骨折临床研究

Clinical Research of Biodegradable Bone Cement Substitute Combined with Pedicle Screw Internal Fixation in Treatment of Thoracolumbar Spine Fractures

目的观察可吸收骨水泥强化椎体联合短节段椎弓根钉内固定治疗胸腰段脊柱骨折的疗效。方法自2009年2月-2011年5月应用经伤椎椎弓根注射可吸收骨水泥强化,联合短节段椎弓根钉内固定治疗胸腰段脊柱骨折26例。所有患者均于术前、术后1周、2个月、6个月、12个月、去除内固定后3个月行X线检查;术前、术后6个月、12个月行CT检查,测量后凸角及伤椎前缘高度的变化。术后随访10～36个月,平均18个月。结果所有病例均无神经损伤或异物反应等并发症。未发现有内固定松动或断裂现象。术前后凸角平均21.8°,椎体前缘高度平均为49.7%,术后1周分别为3.2°和94.3%;术后12个月3.8°和92.3%;去除内固定后3个月5.5°和90.4%。并进行SPSS 12.0统计软件进行统计分析,差异具有统计学意义(P<0.05)。结论可吸收骨水泥联合短节段椎弓根钉内固定治疗胸腰段脊柱骨折可有效恢复椎体高度及后凸畸形,促进椎体骨折愈合,减少远期椎体高度丢失,同时也是防止椎弓根钉松动或断裂的有效方法。

Objective To observe the effects of vertebral bodies augmentation using biodegradable bone cement substitute combined with posterior pedicle screw-based systems on thoracolumbar burst fractures. Methods Twenty-six patients with thora- columbar fractures from Feb. 2009 to May 2011 underwent vertebral bodies augmentation using biodegradable bone cement substi- tute combined with short segment pedicle internal fixation. X-ray and CT scanning were performed to evaluate the recovery of the injured vertebrae in all patients according to the schedule before and after the operations. They were followed up for 10 - 28 months（ average 14 months）. Results All patients obtained successful surgery without neurological complications or foreign body response. There were no slack or fractured screws. All patients were perfectly healed without further loss of vertebral height reduc- tion or kyphotic deformity angle. The statistical analysis showed that the difference was significant （ P 〈 0.05 ）. Conclusion Bio- degradable bone cement substitute combined with short-segment pedicle screw internal fixation in the treatment of thoracolumbar spinal fracture and kyphosis can be effective in restoring vertebral height, vertebral fracture healing, and can reduce long-term vertebral height loss, also prevent the loosening or fracture of vertebral pedicle screw.