经椎弓根植骨预防骨折后椎体塌陷的疗效观察

目的探讨经椎弓根椎体内植骨治疗胸腰椎骨折的疗效。方法采用植骨器械经椎弓根椎体内植骨，结合椎管减压、短节段椎弓根螺钉固定治疗胸腰椎骨折52例并获得2年以上随访。测量伤椎椎体中央高度值，比较植骨后椎体高度的恢复程度，观察植骨融合情况。采用配对t检验进行统计学分析。结果52例患者术后随访27～62个月，平均36个月。CT显示椎体内植骨融合良好，伤椎椎体中央高度值与正常值比较，差异无统计学意义（P〉0．05）。6例（12％）出现伤椎椎体塌陷，其中3例后凸成角，内固定失败，再次手术治疗。结论椎管减压及内固定同时经伤椎椎弓根进行椎体内植骨可恢复伤椎椎体高度，重建前、中柱的稳定性可预防术后远期椎体塌陷的发生。

Study on clinical results of transpedicular intracorporeal grafting to avoid collapse of the vertebral body after thoracolumbar fractures

Objective To explore the clinical results of transpedicular intracorporeal grafting in the treatment of thoracolumbar burst fractures.Methods Seventy-one patients with thoracolumbar fractures were treated with transpedicular intracorporeal grafting combined with canal decompression and short segmental transpedicular fixation, and 52 of them got at last 2 years follow-up. The middle height of the injured vertebrae was measured to compare the recovery degree of vertebrae height and to observe the conditions of bone grafting fusion. The results were analyzed by paired t test. Results Fifty-two cases were followed up from 27 months to 62 months, 36.2 months averagely. The fusion of the bone grafting was observed on CT scans. There was no significant difference between the height of reduced and normal vertebrae (P>0.05). Collapsed vertebral bodies were observed in 6 cases (12%) with revision surgery in 3 cases of fixation failure.Conclusion Transpedicular intracorporeal grafting combined with canal decompression and short segmental transpedicular fixation can recover the height of the injured vertebrae, rebuild the stability of anterior-interior column and prevent vertebrae body collapse post-operatively.