中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (35): 6545-6549.doi: 10.3969/j.issn.2095-4344.2012.35.017

• 骨科植入物 orthopedic implant • 上一篇    下一篇

后路椎弓根钉置入内固定结合自体骨植骨治疗胸腰椎爆裂骨折：12个月后伤椎椎体高度随访

谷效斌，朱光伟，相小刚，王 琳   

  1. 三门峡市第三人民医院骨科，河南省三门峡市 472143
  • 收稿日期:2011-12-05 修回日期:2012-03-07 出版日期:2012-08-26 发布日期:2012-08-26
  • 作者简介:谷效斌，男，1963年生，河北省三门峡市人，汉族，1984年郑州大学医学院毕业，副主任医师，主要从事骨与关节病、骨不愈合治疗方面的研究。 guxbgk@126.com

Posterior pedicle screw fixation combined with transpedicular self-bone grafting in the treatment of thoracolumbar burst fractures: Follow-up of the vertebral body height after 12 months

Gu Xiao-bin, Zhu Guang-wei, Xiang Xiao-gang, Wang Lin   

  1. Department of Orthopedics, Third People’s Hospital of Sanmenxia, Sanmenxia 472143 Henan Province, China
  • Received:2011-12-05 Revised:2012-03-07 Online:2012-08-26 Published:2012-08-26
  • About author:Gu Xiao-bin, Associate chief physician, Department of Orthopedics, Third People’s Hospital of Shanmenxia, Shanmenxia 472143 Henan Province, China guxbgk@126.com

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摘要：

背景：随着生物力学和内固定材料领域的迅猛发展，经椎弓根内固定治疗胸腰椎爆裂骨折已成为此类骨折的主要治疗手段。
目的：观察后路椎弓根钉固定结合自体骨植骨治疗胸腰椎爆裂骨折的疗效及相关影响因素。
方法：纳入经后路椎弓根钉固定结合自体骨植骨治疗的胸腰椎爆裂骨折患者47例，测量治疗前后的美国脊髓损伤协会分级和目测类比评分、治疗前后、随访12个月时椎体前后缘压缩率、Cobb角和Oswestry 功能障碍指数分值。
结果与结论：患者均获得随访，治疗后47例患者疼痛均明显缓解，伤椎椎体高度恢复。55%的患者美国脊髓损伤协会分级恢复一二级；与治疗前比较，椎体前缘压缩率、后缘压缩率、Cobb角均显著降低(P < 0.05)。随访12个月时，各项指标有略微的升高，但差异无显著性意义(P >0.05)。说明后路椎弓根钉固定结合自体骨植骨可维持椎体高度，重建脊柱稳定性；影响患者末次随访Oswestry 功能障碍指数分值的相关因素为治疗前和随访12个月椎体前缘压缩率。

关键词: 内固定, 胸腰椎, 爆裂骨折, 压缩率, 植入, 椎体高度, Cobb角, 经后路椎弓根钉固定

Abstract:

BACKGROUND: With the rapid development of biomechanics and fixation materials, pedicle screw fixation has become the main method for the treatment of thoracolumbar burst fractures.
OBJECTIVE: To evaluate the clinical effect and influencing factors of posterior pedicle screw fixation comlined with transpedicular self-bone grafting in the treatment of thoracolumbar burst fractures.
METHODS: Forty-seven thoracolumbar burst fracture patients treated by posterior pedicle screw fixation combined with transpedicular self-bone grafting were selected. American Spinal Injury Association and visual analogue score were measured preoperatively and postoperatively. Vertebral wall compressed ratios, Cobb angel and Oswestry disability index were measured preoperatively, postoperatively and 12 months after follow-up.
RESULTS AND CONCLUSION: All the patients were followed-up. The pain and injured vertebral height were improved obviously. American Spinal Injury Association score of 55% patients was upgraded to 1 or 2 level. Postoperative anterior and posterior vertebral wall compressed ratios and Cobb angel were significantly decreased than preoperative (P < 0.05). After followed-up for 12 months, anterior and posterior vertebral wall compressed ratios and Cobb angel were slightly increased comparing with postoperation, but the difference was not significant (P > 0.05). Posterior fixation and transpedicular self-bone grafting can significantly restore vertebral height and maintain vertebral stability. The main factors affecting the Oswestry disability index score were the anterior vertebral compression rate of preoperatively and 12 months’ follow-up.

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