经皮椎弓根钉内固定联合球囊辅助复位椎体内植骨治疗胸腰椎骨折

The treatment of thoracolumbar fracture with percutaneous pedicle screw fixation combined with balloon assisted reduction and intravertebral body graft

目的探讨经皮椎弓根钉内固定联合球囊辅助复位椎体内植骨治疗胸腰椎骨折的疗效。方法采用经皮椎弓根钉内固定联合球囊辅助复位椎体内植骨治疗19例胸腰椎骨折患者。观察患者手术前后椎体前缘、中部、后缘高度的变化以及后凸Cobb角的矫正程度。结果19例均获得获随访,时间12~24个月。后凸Cobb角以及椎体前缘、中部、后缘高度:术后1周、3个月、12个月与术前比较差异均有统计学意义(P<0.05),术后各时间段比较差异无统计学意义(P>0.05)。术后无内固定物松动及断裂发生。Frankel神经功能分级:3例术前D级者末次随访均改善至E级。结论采用经皮椎弓根钉内固定联合球囊辅助复位椎体内植骨治疗胸腰椎骨折,能够有效恢复和重建伤椎高度,矫正后凸畸形,恢复椎体的生物力学性能。

Objective To investigate the efficacy of percutaneous pedicle screw fixation combined with balloon assisted reduction and intravertebral bone grafting for thoracolumbar fractures.Methods The 19 cases of thoracolumbar fractures were treated with percutaneous pedicle screw fixation and balloon assisted reduction and intravertebral body grafting.The changes in the height of the anterior,middle and posterior edges of the vertebrae,and the correction degree of Cobb angles were evaluated.Results All the 19 cases were followed up for 12~24 months.There were statistically significant differences in postoperative kyphotic Cobb angle,anterior,middle and posterior edge height of vertebrae,compared with the preoperative(P<0.05),while there were not statistically significant differences in postoperative comparison in 1 week,3,12 months after surgery(P>0.05).No loosening or rupture of the internal fixation occurred after the operation.Frankel grades:3 cases of preoperative grade D were restored to E at the final follow-up.Conclusions The treatment of thoracolumbar fracture with the combination of percutaneous pedicle screw internal fixation and balloon assisted reduction and intra-vertebral bone graft can effectively restore and reconstruct the height of the injured vertebra,correct the kyphotic deformity,restore the biomechanical properties of the vertebra.