摘要
目的探讨经伤椎椎弓根植骨联合伤椎椎弓根螺钉固定治疗胸腰椎骨折的临床疗效。方法回顾性研究2006年6月-2009年8月的52例胸腰段段骨折患者,均为AO分型中的A型骨折,采用经伤椎椎弓根植骨联合伤椎椎弓根螺钉固定治疗。患者手术前后和随访均行X线检查,测量伤椎椎体前缘高度值、Cobb＇s角。手术前后CT测量椎管内占位比并评估植骨情况。观察术后并发症和神经功能恢复情况。结果患者随访（16.5±7.8）月（12~30月）。无切口感染、神经症状加重,无内固定松动及断裂。伤椎前缘高度术后和末次随访均较术前恢复满意。Cobb＇s角术后和末次随访无明显矫正丢失。椎管内占位比为较术前明显改善。神经功能较术前均有1～2级的改善。结论伤椎椎弓根植骨可有效修复伤椎复位后的椎体缺损,伤椎椎弓根螺钉固定能有效重建骨折稳定性,前中后三柱重建稳定,是治疗胸腰椎A型骨折的一种有效方法。
Objective To explore the clinical efficacy of transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra for thoracolumbar fractures treatment.Methods A total of 52 patients of thoracolumbar fractures were treated with transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra from June 2006 to December 2009.According to the AO classification,all of them are type A fracture.Preoperative,postoperative and follow-up X-ray were performed for evaluating anterior heights of the injured vertebra（AHIV） and Cobb＇s angle,as well,preoperative and postoperative CT scans were taken to measure the sagittal canal diameter（SCD）.Postoperative complications and neurofunctional recovery of the spinal cord were evaluated.Results All cases were followed up about 12 to 30 months,averagely 16.5±7.8 months.There was no infection of incision and no aggravation of spinal cord function.There was no implant failure and no loss of spinal curvatures.After surgery and at final follow-up,anterior heights of the injured vertebra showed good recovery,and Cobb＇s angel appeared smaller.The sagittal canal diameter significantly reduced compared to that before surgery.In patients with incomplete injury,neurofunctions showed 1 to 2 grade improvement compared with the findings before operation.Conclusions Transpedicular intracorporeal grafting is effective to repair fractured vertebrae in the vertebral body defects,posterior short-segment pedicle screw via the injured vertebra can reconstruct the stability of thoracolumbar fractures,stable reconstruction of the anterior and middle columns and secured fixation of the posterior column.This technique is an effective method for treatment of A type thoracolumbar fractures.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2011年第3期356-360,共5页
Chinese Journal of Clinical Anatomy
基金
国家高科技研究发展计划(863)资助项目(2002AA326020)
重庆市卫生局医学科技计划项目(06-2-020)
关键词
胸腰椎骨折
椎弓根螺钉
内固定
伤椎
植骨
Thoracolumbar fractures
Pedicle screw
internal fixation
Injured vertebra
Bone grafting
