单节段椎弓根固定椎体内打压植骨治疗胸腰椎压缩骨折.pdfVIP

· 134 · 临床骨科杂志 JournalofClinicalOrthopaedics 2012Apr；15(2) · 临床论著 · 单节段椎弓根固定椎体内打压植骨治疗胸腰椎压缩骨折 邢 飞，樊道斌，陈宏赋，张林胜，朱 敏 摘要：目的 探讨单节段椎弓根固定结合伤椎打压植骨治疗胸腰椎屈曲压缩骨折的疗效。方法 对 15例胸 腰椎压缩性骨折(DenisB型)患者行后路单节段经伤椎复位固定、经椎弓根伤椎打压植骨手术。测量术前术 后Cobb角，计算伤椎高度恢复率，进行 ODI评分，分析疗效。结果 15例患者均获随访，时间6～18个月。 伤椎高度矫正率约95％，Cobb角由术前的14。～25。改善为术后的3。一8。。未出现内固定断裂、神经损伤等 并发症。结论 单节段椎弓根固定椎体内植骨治疗胸腰椎压缩性骨折手术创伤小，仅固定 1个运动节段；椎 体内打压植骨有效解决椎体复位后产生的椎体内骨缺损。 关键词 ：胸腰椎骨折；单节段；椎弓根螺钉固定；椎体内打压植骨 中图分类号：R683．2；R687．3 文献标识码：A 文章编号：1008～0287(2012)02—0134—03 Treatmentofthethoracolumbarspinefracturewithposteriormonosegmentpediclefixation andtranspedicularimpactedbonegraft atinjuredlevel XINGFei，FANDao—bin，CHEN ， ZHANGLin—sheng，ZHUMin (DeptofSpinalSurgery，ChaohuOrthopedicHospital， Chaohu．Anhu238OD0，China) Abstract：Objective Toexploretheclinicaleffectsofposteriormonosegmentalpediclescrewfixationinselective treatmentofthoracolumbarvertebral fractures．M ethods 15patientswiththoracolumbarfracturesweretreatedwith posteriormonosegmentalpediclescrew fixationandtranspedicleimpactedbonegraf1．TheCobbSangleandreduction ofinjuredvertebralbodyheightwereobserved．Results Allcaseswerefollowedupfor6～18months．Clinicalevalu— ationrevealedthat11caseshadnopain，4caseswithoccasionalpainbutrequirednomedicationandallpatientshad ahighlevelofsatisfactionwiththefinalresults．Radiographicevaluationrevealedreductionrateoftheinjuredverte— bralheightwas95％ ．TheCobbSanglewasrestoredfrom 14。一25。to3。一8。．Therewasnoimplantbreakage．and nosignsofpseudoarthrosiswereobserved．Conclusions Posteriormonosegmentalfixationmightbeanadequateand effectiveproceduretobeusedinspecifictypesofthoracolumbarspinefractures．Transpedicularimpactedgraftingaf- terbonelosscalculationcombinedwithpediclefixationhasbetterbiomechanicalproperties． Keywords：thoracolumbarfractures；monosegmental；pedicalfixation；transpedicu|arimpactedgrafting 胸腰段骨折是一种常见的脊柱创伤，后路短节 例 。分