后路经伤椎椎弓根钉短节段固定治疗胸腰段椎体骨折

Posterior short-segment pedicle internal fixation at the injured vertebrae for thoracolunbar spine fractures

目的探讨后路经伤椎椎弓根钉短节段固定治疗胸腰段椎体骨折的临床疗效。方法将自2007-01—2010—12收治的66例胸腰段椎体骨折随机分为后路短节段椎弓根内固定组（A组）和短节段经伤椎内固定组（B组），采用疼痛模拟视觉评分（VAS）、伤椎前缘高度比值及伤椎Cobb角比较组问差异。结果所有患者获随访12．18个月。平均14．8个月。2组手术前后VAS评分、伤椎前缘高度改善和Cobb角恢复比较差异均有统计学意义（P〈0．001）；B组VAS评分、伤椎前缘高度改善和Cobb角恢复明显优于A组，差异有统计学意义（P〈0．05）。结论后路经伤椎椎弓根钉短节段固定时是治疗胸腰段椎体骨折疗效可靠的内固定方法。

Objective To investigate indications, operation method and clinical outcome of posterior short-segment pedicle at the injured level for thoracolunhar spine fractures. Methods From January 2007 to December 2010, 66 cases of thoracolunbar fractures were equally randomized to group A （treated with short-segment pedicle screw fixation） and group B （treated with short-segment pedicle screw fLxation at the injured level）. There were 47 male and 19 female,ranging from 26 to 52 years of age （mean 45.8 years） at surgery. Preoperative and postoperative VAS score, anterior heights of the injured vertebral body and Cobb＇s angle and internal fLxation were assessed and compared clinically. Results All patients were followed up for 12 to 18 months （mean 14.8 months）. In each group, there were significant differences before and after operation （P 〈0.001） in the VAS score, anterior heights of the injured vertebral body and Cobb＇s angle. Compared with group A, group B had significantly better improvement （P 〈0.05） in the VAS score, anterior heights of the injured vertebral body and Cobb＇s angle. The screw breakage occurred in three in group A, while there was no implant breakage, loosening or emersion in group B. Conclusion Posterior short-segmental fixation at injured level is an adequate and effective method for compression fracture and mild to moderate burst fracture of the thoracolumbar spine.