中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (43): 8075-8078.doi: 10.3969/j.issn.1673-8225.2011.43.024

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

伤椎后路椎弓根螺钉置入并椎体内植骨重建胸腰椎椎体的高度

付  裕，霍洪军，杨学军，肖宇龙，邢文华，赵  岩   

  1. 内蒙古医学院第二附属医院胸腰椎脊柱外科，内蒙古自治区呼和浩特市  010030
  • 收稿日期:2011-06-30 修回日期:2011-08-26 出版日期:2011-10-22 发布日期:2011-10-22
  • 作者简介:付裕☆，男，1979年生，内蒙古自治区鄂尔多斯市人，汉族，重庆医科大学在读博士，主治医师，主要从事脊柱外科的研究。 fuyu-spine@163.com
  • 基金资助:

    内蒙古医学院第二附属医院重点课题项目。

Reconstructed thoracolumbar height following posterior transpedicular pedicle screw fixation and bone graft

Fu Yu, Huo Hong-jun, Yang Xue-jun, Xiao Yu-long, Xing Wen-hua, Zhao Yan   

  1. Department of Spinal Surgery, the Second Affiliated Hospital of Inner Mongolia Medical College, Hohhot  010030, Inner Mongolia Autonomous Region, China
  • Received:2011-06-30 Revised:2011-08-26 Online:2011-10-22 Published:2011-10-22
  • About author:Fu Yu☆, Studying for doctorate, Attending physician, Department of Spinal Surgery, the Second Affiliated Hospital of Inner Mongolia Medical College, Hohhot 010030, Inner Mongolia Autonomous Region, China fuyu-spine@163.com
  • Supported by:

    the Major Project of the Second Hospital Affiated to Inner Mongolia Medical College*

PDF

343

被引次数

9

摘要：

背景：后路短节段经椎弓根内固定器械可使骨折达到近似解剖复位效果，明显提高疗效，但远期随访矫形度数丢失、内固定失败等并发症较普遍。
目的：探讨经伤椎椎弓根螺钉置入固定结合经椎弓根植骨治疗胸腰椎骨折的可行性。
方法：对73例胸腰椎骨折应用椎弓根钉棒系统后路伤椎一侧椎弓根螺钉置入内固定，对侧经椎弓根通道采用自体骨和同种异体骨行椎体内植骨。
结果与结论：73例随访6个月内均获骨性愈合，脊柱植骨融合率100%，无螺钉松动、折断。1例Frankel分级C级无变化，1例D级无变化，其余患者神经功能及腰背痛明显改善；置入后6个月损伤节段后凸平均Cobb角、伤椎椎体前缘高度、椎管前后径残留程度均较治疗前明显恢复。表明经伤椎椎弓根钉置入内固定结合经椎弓根植骨治疗骨折可获得满意复位，重建椎体高度，增强脊柱的抗压稳定性，减少内固定因应力过大造成的断钉、矫正丢失等并发症。

关键词: 伤椎, 椎弓根, 螺钉, 植骨, 固定, 骨科植入物

Abstract:

BACKGROUND: Posterior short segment pedicle screw fixation devices can achieve similar anatomic fracture reduction effect and significantly improve the outcome, but the loss of orthopedic degree during long-term follow-ups, fixation failure and other complications are commonly seen.
OBJECTIVE: To study the feasibility and curative effect of posterior transpedicular pedicle screw fixation and bone graft for thoracolumbar fractures.
METHODS: Seventy-three thoracolumbar vertebra fracture patients treated by unilateral pedicle screw fixation and contralateral autologous and allogeneic bone graft.
RESULTS AND CONCLUSION: All the patients achieved bone union within 6 months, and the fusion rate was 100%. No screw loosening and breaking occurred. One case of Frankel grade C had no change, and 1 case of Frankel grade D had no change. The remaining patients had an improvement in neurologic function and low back pain; The Cobb angle of the injured segment, the height of anterior border of the injured vertebral body and the vestigial degree of canalis spinalis anteroposterior diameter were significantly restored with 6 months after treatment. Vertebral pedicle screw fixation with transpedicular bone graft cannot only reduce verbebral fracture satisfactorily, reconstruct thoracolumbar height, increase the stability of the spine, but also decrease the possibility of nail breaking and correction loss.

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