40例后路钉棒系统内固定结合后外侧植骨治疗胸腰段脊椎骨折

40 cases of posterior pedicle screw internal fixation combined with posterolateral bone grafting for the treatment of thoracolumbar vertebral fractures

目的:探讨后路钉棒系统与后外侧植骨相结合运用于胸腰段脊椎发生骨折的临床效果。方法:通过将我院2015年4月~2016年4月间收治并持续随访的40例胸腰脊椎骨折患者采用后路钉棒系统进行内固定并融合后外侧方植骨合并疗法进行回顾性分析,并在疗程后比较这40例患者治疗前后的椎体后缘高度、Cobb角度的变化以及椎体前缘高度、椎楔变角、骨融合等临床指标,此外,对脊髓神经功能的恢复也进行相应比较,也对ODI进行相应评分分析其并发症。结果:术后、术后6个月椎体前缘高度、椎体后缘高度较术前显著增高(P<0.05),Cobb角、椎楔变角较术前显著变小(P<0.05),骨融合比例较术前均显著降低(P<0.05),ODI评分较术前显著降低(P<0.05);术后6个月,A、B、C、D、E级各例数较术前显著改善(P<0.05):术后1例出现内固定不稳,术后6个月5例出现并发症,主要是慢性骨位疼痛。结论:对于腰胸段脊椎骨折的患者,采取后外侧植骨结合后路钉棒系统疗法在临床上治疗效果显著,安全性高,值得推广采用,能有效提高患者生活质量。

Objective： To investigate the posterior screw system and posterolateral bone grafting combined with clinical effect on thoracolumbar spine fracture. Method： By our hospital from April 2015 -2016 year in April and continued follow-up of 40 cases of thoracolumbar vertebral fracture were treated with posterior pedicle screw fixation and posterolateral fusion of side grafting combined therapy of bone were retrospectively analyzed, and compared the 40 patients before and after treatment in the treatment of vertebral height, Cobb angle and the change of anterior vertebral height, vertebral wedge angle, bone fusion and other clinical indicators, in addition to the recovery of the spinal nerve function were also compared, the corresponding ODI score analysis the complications. Result： After operation, 6 months after the operation of anterior vertebral height, posterior vertebral height was significantly higher than preoperative （P〈0.05）, Cobb angle, vertebral wedge angle was significantly smaller than that before operation （P〈0.05）, bone fusion ratio was Group decreased （P〈0.05）, ODI score decreased significantly （P〈0.05）; 6 months after the operation, A, B, C, D, E levels were significantly improved compared with that before operation （P〈0.05）; after 1 cases of internal fixation instability, 6 months after operation in 5 cases complications, especially chronic bone pain. Conclusion： For patients with thoracolumbar spine fractures, the use of posterior lateral bone grafting combined with posterior screw rod system therapy in the clinical treatment of significant effect, high safety, it is worth promoting,can effectively improve the quality of life of patients.