经伤椎椎弓根植骨螺钉固定治疗胸腰段骨折

Treatment of thoracolumbar fractures with vertebral pedicle screw in fractured vertebral

目的探讨经伤椎椎弓根螺钉治疗胸腰段骨折的临床疗效及应用价值。方法收集2009-01—2013-01间胸腰段骨折手术患者58例,A组为跨伤椎椎弓根螺钉内固定共计30例,B组为经伤椎椎弓根螺钉内固定共计28例,分别测量术前术后伤椎相邻椎体矢状位Cobb角、计算椎体压缩比,并对术前术后症状改善情况进行评分。结果 A组矢状位Cobb角术前平均25.4°,术后平均减少至11.3°,椎体压缩比术前平均57.8%,术后平均增加到89.1%。B组矢状位Cobb角术前平均25.7°,术后平均减少至10.1°,椎体压缩比术前平均58.2%,术后平均增加到92.3%。两组间对比可见B组术后伤椎相邻椎体后凸矫正程度及椎体压缩复位程度均好于A组。结论经伤椎椎弓根螺钉内固定治疗脊柱胸腰段骨折对矫正脊柱后凸畸形及恢复椎体高度相比跨伤椎椎弓根螺钉内固定更为有效,但应根据不同病例进行选择性应用。

Objective To explore the clinical curative effect and the application value of the treatment of thoracolumbar fractures with vertebral pedicle screw in fractured vertebral .Methods Collected 58 patients with thoracolumbar fracture from 2009-01-2013-01.All the patients were treated by posterior fixation surgery .30 cases of patients in group A were fixed across the fractured vertebral .The other 28 cases patients of group B were fixed in the fractured vertebral .Two groups were measured injured vertebra adjacent vertebral sagittal Cobb Angle , and calculated vertebral height compression ratio .To assess the patients＇symptoms and signs before and after operation .Results The average Cobb angle of group A was dropped from 25.4°preoperative to 11.3°postoperative, and the average vertebral height compression ratio increased from 57.8%preoperative to 89.1%postoperative.The average Cobb angle of group B was dropped from 25.7°preoperative to 10.1° postoperative, and the average vertebral height compression ratio increased from to 58.2%preoperative to 92.3% postoperative.By comparison between the two groups before and after operation , The kyphosis correction of injured vertebral bodies and the degree of vertebral compression restoration of group B were better than that of group A .Conclusion The clinical curative effect of the treatment of thoracolumbar fractures with vertebral pedicle screw in the fractured vertebral is better than that across the fractured vertebral .It can better correct the degree of kyphosis and restore the vertebral height .But should be selectively applied according to different cases .