后路短节段固定、伤椎椎弓根钉固定联合植骨治疗胸腰椎爆裂性骨折的中远期疗效分析

The medium and long-term effects of posterior short segment pedicle screw fixation and bone grafting in the treatment of thoracolumbar burst fractures

目的：探讨后路短节段固定、伤椎椎弓根钉固定联合植骨治疗胸腰椎爆裂性骨折的中远期疗效。方法采用后路短节段固定、伤椎椎弓根钉固定联合植骨治疗38例胸腰椎爆裂性骨折患者，比较治疗前后椎体高度、Cobb角、Frankel 分级及 Christian 评分。结果全组患者随访31～55月，末次随访时椎体前高及后高均显著优于治疗前（均 P ＜0．05），Cobb 角显著减少（P ＜0．05）；治疗后 Frankel 分级显著优于治疗前（P ＜0．05）；Christian 评分：3分1例，4分1例，5分11例，6分16例，7分9例；椎体内植骨融合良好，未发生内固定松动及断裂。结论后路短节段固定、伤椎椎弓根钉固定联合植骨治疗胸腰椎爆裂性骨折的中远期疗效理想。

Objective To explore the medium-and long-term effects of posterior short segment pedicle screw fixation and bone graft in the treatment of thoracolumbar burst fractures.Method From January 2009 to January 2011, 38 cases with thoracolumbar burst fractures were selected as subjects.All the subjects underwent posterior short segment pedicle screw fixation and bone graft treatment.Vertebral height, cobb angle, frankle classification and Christian grade were evaluated. Findings The patients were followed up 31 to 55 months after the operation, 46.8 months on the average; At the final follow-up, heights of anterior and posterior vertebral body were significantly superior to pre-operation;Cobb angles on final follow-up also significantly decreased（P 〈0.05）; Frankle classification on final follow-up was superior to pre-operation （P 〈0.05）; Christian grades： 3 points in 1 patients, 4 points in 1 patients, 5 points in 11 patients, 6 points in 16 patients and 7 points in 9 patients; Graft bone fusion were excellent and the internal fixations were firm.Conclusion Posterior short segment pedicle screw fixation and bone grafting have ideal medium-and long-term effects in treating thoracolumbar burst fractures.