经椎弓根植骨联合骨水泥强化螺钉在骨质疏松椎体骨折的临床应用

Clinical application of transpedicular bone graft and augmented pedicle screw fixation with bone cement in the treatment of osteoporotic spinal compression fractures

目的：探讨经椎弓根植骨联合骨水泥强化螺钉植入技术对骨质疏松椎体骨折患者手术治疗的临床疗效。方法：总结2007年6月~2011年10月以来采用经椎弓根植骨联合骨水泥强化螺钉植入技术治疗骨质疏松椎体骨折22例,回顾分析患者术前术后临床及影像学资料和随访结果,观察椎弓根螺钉术中及术后的稳定性,并对术后并发症进行观察。结果：术后22例患者获随访,随访时间12~48个月（平均26.6个月）,均获得骨性愈合,愈合时间为6个月~8个月,X线片显示内置物无松动、折断或脱落,螺钉周围未见透亮线出现,椎体高度丢失平均5%,无神经及脏器损伤等并发症发生。结论：运用经椎弓根植骨联合骨水泥强化螺钉植入技术治疗骨质疏松椎体骨折,增加了椎弓根螺钉的把持力,增强了脊柱的稳定性,克服了螺钉松动和复位矫正丢失等并发症的发生。手术操作简单,安全性高。

Objective To investigate the clinical efficacy of the techniques of transpedicular bone graft and augmented pedicle screw fixation with bone cement in the treatment of osteoporotic spinal compression fractures.Method From June 2007 to December 2011,22 cases of osteoporotic spinal compression fractures were treated with the techniques of transpedicular bone graft and augmented pedicle screw fixation with bone cement.The cases were analyzed retrospectively,including pre and postoperative clinical and images data.The stability of pedicle screw surgery and postoperative were observed.Complications were given analysis too.Results 22 patients were followed up for 12 ~ 48 months,an average of 26.6 months22,cases were of bone union,the healing time of 6 to 8 months,X-ray showed no fixation loose or broken off,yet bright lines appear around screw.The loss of correction of reduction in fractures was 5%.No complications arising from operation were found.Conclusion Transpedicular bone graft and augmented pedicle screw fixation with bone cement can enhance the stability of spine in the treatment of osteoporotic spinal compression fractures.The techniques have the following advantages,keeping the vertebral height,increasing the holding force of pedicle screw,avoiding loose of screw and loss of correction surgjcal operation is easy to operate and safe.