经伤椎椎弓根植骨结合膨胀型椎弓根钉固定治疗老年性胸腰椎骨折

Transvertebral bone grafting combined inflating pedicle screws internal fixation for thoracolumbar fracture in eldly patients

目的探讨经伤椎椎弓根椎体内植骨结合膨胀型椎弓根钉固定治疗老年性胸腰椎骨折的临床疗效。方法对2010年2月～2012年3月收治的32例65岁以上的老年胸腰椎骨折患者行手术治疗的临床资料进行回顾性分析,行后路经伤椎椎弓根椎体内植骨结合膨胀型椎弓根螺钉复位内固定术。术后随访观察椎弓根螺钉稳定性、脊柱融合率、术前及术后疼痛视觉模拟量表(visual analogue scale,VAS)评分、伤椎Cobb角、椎体前后缘高度改善情况。结果 32例患者获得术后平均16个月的随访,所有患者螺钉稳定性及骨融合良好。VAS评分、Cobb角矫正、椎体前后缘高度均较术前明显改善。结论经椎弓根椎体内植骨结合膨胀型椎弓根钉固定治疗老年性胸腰椎骨折在促进骨折愈合、改善疼痛及减少术后后凸畸形方面均具有良好的临床疗效。

Objective To explore the clinical curative effect of transvertebral bone grafting combined inflating pedicle screws internal fixation for thoracolumbar fracture in eldly patients. Methods From February 2010 to March 2012 , clinical data of 32 thoracolumbar fracture cases over 65 years old were retrospectively analyzed. All the cases underwent posterior transvertebral bone grafting combined inflating pedicle screws internal fixation. The screw stability, spinal fusion rate, per- and postoperation visual analogue scale （VAS） scores, Cobb＇ s angle and vertebral height improvement were observed. Results All cases were followed up, at a mean time of 16 months. Screw stability and good bone fusion were observed in all patients. VAS score, Cobb＇ s angle, vertebral height correction were significantly improved compared with preoperative. Conclusion Transvertebral bone grafting combined inflating pedicle screws internal fixation for thoracolumbar fracture in eldly patients has good clinical curative effect in enhancing the fracture healing, improving pain and reducing postoperative kyphosis.