同种异体骨结合自体骨经伤椎椎弓根椎体内植骨治疗胸腰椎骨折的临床研究

Treatment of thoracolumbar vertebral fracture by autologous and allogeneic bone graft through pedicle of fracture vertebra combined with pedicle screw fixation in other side and posterior short segment fusion

目的探讨同种异体骨结合自体骨经伤椎椎弓根植入并对侧置钉后路短节段固定在治疗脊柱胸腰段骨折中的临床应用及对伤椎高度与外形恢复的影响和疗效。方法自2008一01—2011—12应用同种异体骨结合自体骨经伤椎一侧椎弓根通道椎体内植入并对侧置钉，同时行脊柱短节段后路融合固定治疗胸腰椎骨折42例。结果42例中有39例获得随访，随访时间为11．O～34．3个月，平均28．4个月。其中1例在术后11个月出现断钉，予以及时取出，未发生神经损伤情况，其余38例均未出现内固定物松动、断钉断棒现象。结论应用同种异体骨结合自体骨经伤椎一侧椎弓根通道椎体内植入并对侧置钉，能即刻恢复伤椎的高度与外形，重建脊柱的生理结构，是一种较为理想的临床治疗方法。

Objective To explore the clinical application of autologous and allogeneic bone graft through pediele of the fracture vertebra combined with pedicle screw fixation in the other side and posterior short segment fusion in the treatment of thoracolumbar vertebral fracture and effect on the height and shape of the fracture vertebra. Methods Between January 2008 and December 2010, 42 patients with thoracolumbar vertebral fracture were treated by autologous and aUogeneie bone graft through pedicle of the fracture vertebra combined with pedicle screw f＇rxation in the other side and posterior short segment fusion. Results In the 42 patients, 39 patients were followed up for 11.0-34.3 months （mean 28.4 months）. There were the screws broken in one of the 39 cases which were removed in time. But there were no nerve injury. The remaining 38 cases had no loosening or breakage of screws and rods. Conclusion The treatment of thoracolumbar vertebral fracture by autologous and allogeneic bone graft through pedicle of the fracture vertebra combined can restore the better height and shape of fracture vertebra, reconstruction the strueture of spine, so this operation is an effective treatment.