椎弓根内固定 骨水泥注入椎体成形术治疗胸腰椎骨折

Tomodifyposteriorprocedures forthoracolumbar fracture

目的 改进后路手术治疗胸腰椎骨折的方法。 方法 12例胸腰椎骨折患者 ,伤椎前缘压缩均>50% ,行后路切开复位短节段椎弓根内固定后 ,用骨水泥经伤椎椎弓根注入椎体成形术。所有病例均于术前、术后行X线和CT检查。术后随访5～12个月 ,平均13个月。结果 手术均获成功 ,术后3例术前有神经症状的患者神经症状恢复 ,无骨水泥渗漏 ,无异物反应 ,术后随访无内固定失败及伤椎高度明显丢失者。 结论 后路切开复位椎弓根内固定和骨水泥椎体成形术为胸腰椎骨折提供了一种新的治疗方法。

Objective To modify the posterior procedures for thoracolumbar fracture. Methods 12cases of thoracolumbar fracture with over50%of anterior compression were studied.After reduction and fixation with short-segment pedicle instrumentation was performed,the transpedicular vertebroplasty of fractured vertebrae with PMMA was carried out.All patients were checked with X-ray and CTscanning before and after operation.They were followed-up for5-12months(average8.5months). Results All patients obtained successful surgery without extrusion and foreign body response.3cases with neurological complications were recovery on postoperative.All patients were perfectly recoverd without notable correction loss on implant failure during the follow-up Conclusion Reduction and fixation with short-segment pedicle instrumentation followed by vertebroplasty with PMMA is a promising procedure for thoracolumbar fracture.