后路经椎管内椎体植骨结合椎弓根螺钉系统固定治疗严重腰椎爆裂性骨折的临床研究

posterior pedicle screw fixation with intraspinal canal bone grafting for the treatment severe lumbar burst fracture

目的探讨后路经椎管内椎体植骨结合椎弓根螺钉系统固定治疗腰椎爆裂性骨折的临床疗效。方法回顾性分析泰安市中心医院骨科2006年12月-2012年12月共68例腰椎爆裂性骨折患者,31例为后路椎管减压经椎管内椎体植骨结合椎弓根螺钉系统固定,37例为单纯椎管减压椎弓根螺钉系统固定,随诊6~48个月,评价两组术前、术后及随诊时伤椎高度比值、脊柱后凸成角矫正、腰背疼痛并发症、内固定失效情况。结果经椎管内椎体植骨结合椎弓根螺钉系统固定术后椎体前缘高度及术后后凸成角丢失少,内固定失效率低,与单纯内固定无植骨组比较具有统计学差异（P〈0.05）。结论经椎管内椎体植骨结合椎弓根螺钉系统固定能有效防止复位固定后的矫正丢失和内固定失效,对治疗严重腰椎爆裂性骨折有良好的临床疗效。

Objective To explore the clinical effect of posterior spinal vertebral bone grafting with pedicle screw system fixation for the treatment of thoracolumbar burst fractures.Methods Retrospective analysis of Tai’an Central Hospital Department of orthopedics 2006.12-2012.12 total of 68 patients with columbar burst fracture patients,31 cases of posterior decompression by intraspinal vertebral bone grafting combined with pedicle screw fixation,37 cases underwent spinal canal decompression and pedicle screw system fixation,followed up for 6 ~ 48 months,two groups were evaluated before surgery,and the diagnosis of vertebral height ratio,the spinal kyphosis correction,low back pain,complications of internal fixation failure.Results After intraspinal vertebral bone grafting with anterior height of vertebral body and pedicle screw system fixation surgery postoperative kyphosis angle lost less,internal fixation failure rate is low,and simple internal fixation without bone graft group with statistical difference（P ＆lt; 0.05）.Conclusion The intraspinal bone grafting with pedicle screw fixation system can effectively prevent correction loss after reduction fixation and internal fixation failure,have a good clinical effect on the treatment of serious lumbar burst fractures.