椎弓根固定结合经伤椎椎体内植骨治疗胸腰椎骨折的疗效观察

Curative Efficacyof Treatment of Thoracolumbar Fracture with Internal Fixation and Bone Graft Through Pedicle of Fractured Vertebra

目的：探讨椎弓根固定结合经伤椎椎体内植骨治疗胸腰椎骨折的疗效。方法：选取胸腰椎骨折患者50例,椎弓根固定结合经伤椎椎体内植骨25例为观察组,单纯行椎弓根钉内固定术25例为对照组。术后随访1~1.5年,平均1.3年,所有患者术后均无死亡、创口和深部组织感染并发症、断钉、螺钉松动、纵杆移位发生。观察两组术后2天、术后1年取出内固定物后伤椎椎体高度、Cobb＇s角的变化。结果：伤椎体高度及Cobb＇s角在术后2天两组比较无统计学意义（P〉0.05）,术后1年内固定取出后两组比较有统计学意义（P〈0.05）。结论：经伤椎椎弓根内固定联合伤椎椎体内植入自体骨可增加前中柱的稳定性,恢复伤椎体高度及促进骨性融合,减少内固定松动及断裂、伤椎再次塌陷,比单纯椎弓根内固定手术效果好。

Objective： To explore the prostecdtive efficacy of treatment of thoracolumbar fracture with internal fixation and bone graft through pedicle of fractured vertebra. Methods： 50 patients with thoracolumbar burst fractureswere divided into two groups,observation group（ patients with pedicle fixation combined with h vertebral body bone graft,n = 25） and control group（ patients with simple line of pedicle screw fixation,n = 25）. Followed up 1 ~ 1. 5 years（ an average of 1. 3years）,all patients had no postoperative death,wounds,and deep tissue infection complications,screw breakage and screw loosening,and vertical pole shift. The height of fractured vertebra and the changes of Cobb angle of the two groups were observed 2 days after the operation and 1 year after the internal fixation was harvested. Results： There were no significant differences about the Cobb angle and the height of fractured vertebra between two groups two days after te operation. After 1 year there were significant differences between the two groups after internal fixations were removed. Conclusion： After Combining internal vertebral pedicle screw fixation with internal vertebral body implantation into autologous bone can increase the stability of the column,and promote the vertebral height restoration and bony fusion,reduce the internal fixation loosening and fracture andvertebral collapsion again. It is better than the simple pedicle internal fixation.