经伤椎单侧置钉短节段固定结合椎体植骨治疗胸腰椎爆裂骨折的临床效果

Clinical effect of unilateral screw placement and short segment fixation through injured vertebra combined with vertebral bone grafting in the treatment of thoracolumbar burst fractures

目的探讨经伤椎单侧置钉短节段固定结合椎体植骨治疗胸腰椎爆裂骨折的临床效果。方法回顾性分析2013年3月至2019年10月于我院骨科住院的36例胸腰椎爆裂骨折患者的临床资料。患者均行经伤椎单侧置钉短节段固定结合椎体植骨治疗。分析患者的一般资料及临床疗效指标。结果36例患者中,男29例,女7例;年龄22~65岁,平均(46.94±9.83)岁;随访时间3~24个月,平均(14.31±5.85)个月;爆裂性骨折Denis分类为A型20椎,B型16椎;Frankel分级为C级1例,D级9例,E级26例。所有患者均顺利完成手术,无不良事件发生;平均手术时间为(132.36±37.43)min;平均术中出血量为(274.44±103.00)mL;平均术后引流量为(254.17±74.27)mL;末次随访,所有Frankel分级C级、D级患者均恢复到E级。所有患者术后、末次随访的VAS评分、伤椎椎体前缘高度比、伤椎后凸Cobb角均优于术前(P<0.05)。结论经伤椎单侧置钉短节段固定结合椎体植骨治疗胸腰椎爆裂骨折安全有效。

Objective To explore the clinical effect of unilateral screw placement and short segment fixation through injured vertebra combined with vertebral bone grafting in the treatment of thoracolumbar burst fractures.Methods The clinical data of 36 patients with thoracolumbar burst fractures hospitalized in the orthopedics department of our hospital from March 2013 to October 2019 were analyzed retrospectively.All patients were treated with unilateral screw placement and short segment fixation through injured vertebra combined with vertebral bone grafting.The general data and clinical efficacy indexes of patients were analyzed.Results Among the 36 patients,there were 29 males and 7 females;the age ranged from 22 to 65 years,with an average of(46.94±9.83)years;the follow-up time ranged from 3 to 24 months,with an average of(14.31±5.85)months.According to Denis classification of burst fracture,there were 20 vertebrae of type A and 16 vertebrae of type B.According to Frankel classification,there were 1 case of grade C,9 cases of grade D and 26 cases of grade E.All patients successfully completed the operation without adverse events.The average operation time was(132.36±37.43)min.The average intraoperative bleeding volume was(274.44±103.00)mL.The average postoperative drainage volume was(254.17±74.27)mL.At the last follow-up,all patients with Frankel grade C and D recovered to grade E.The VAS score,anterior vertebral height ratio and Cobb angle of kyphosis of patients after operation and the last follow-up were better than those before operation(P<0.05).Conclusion Unilateral screw placement and short segment fixation through injured vertebra combined with vertebral bone grafting in the treatment of thoracolumbar burst fractures is safe and effective.