椎体成形术结合椎管减压治疗伴有不同节段腰椎管狭窄症的胸腰段压缩性骨折

Spinal decompression combined with vertebroplasty for management of thoracolumbar compres-sion fractures with spinal stenosis of different segmentals

目的探讨是否可以采用椎体成形结合椎管减压椎弓根钉棒内固定的方法治疗伴有腰椎管狭窄症的胸腰段骨折，并评价其疗效。方法选取胸腰椎压缩性骨折合并其他节段腰椎管狭窄症患者，共计23例。其中，10例患者只实施了椎体成形术，为对照组；13例患者实施椎体成形术后采用椎管减压的方法同时治疗其他节段的椎管狭窄，为减压组。结果所有患者压缩性骨折椎体均获得良好复位，减压组患者神经受压及椎管狭窄症状缓解明显。减压组患者术后腰椎JOA评分明显优于对照组（P〈0．0001）。结论椎体成形结合椎管减压椎弓根钉棒内固定不失为治疗伴有腰椎管狭窄症的胸腰段椎体压缩性骨折的有效方法。

Objective To investigate the feasibility of using spinal decompression combined with vertebroplasty for the treatment management of lumbar spinal stenosis with thoracolumbar fractures, and evaluate its efficacy. Methods 23 cases were selected, all the cases suffering from thoracolumbar fractures with spinal stenosis of different segments. 10 patients accepted the vertebroplasty simply, for the control group; 13 patients accepted spinal decompression for the treatment of spinal decompression after vertebroplasty, for the case group. Results All patients have received good reset of the vertebral compression fractures. Patients with symptoms of nerve compression spinal stenosis in case group obtained significant relief. Lumbar JOA score of the case group was significantly better than the control group （P 〈 0.0001）. Conclusion This method could be regarded as an effective method for the management of thoracolumbar compression fractures with spinal stenosis of different segmentals.