经椎板开窗减压复位加经椎弓根植骨和内固定术治疗胸腰椎爆裂性骨折

目的分析经后路椎弓根内固定加经椎板开窗椎管减压和经椎弓根椎体植骨治疗胸腰椎爆裂性骨折的疗效。方法对28例胸腰椎新鲜爆裂性骨折,患者应用后路椎弓根内固定复位,椎板开窗减压+经伤椎椎弓根向椎体前缘植入自体骨及同种异体骨或人工骨。结果术后椎体高度及生理弧度恢复满意,经随访18个月,椎体高度无明显丢失,椎体无塌陷变形,无内固定松动、断裂。结论经后路椎弓根内固定+经椎板开窗减压复位+经椎弓根椎体植骨治疗胸腰椎新鲜爆裂性骨折,手术安全,效果满意,术后并发症低,远期脊柱稳定性好。

Vertebral lamina fenestration decompression reduction & transpedicular bone grafting & internal fixation for thoracolumbar burst fracture

Objective To study the curative effectiveness of posterior transpedicular screw internal fixation+vertebral lamina fenestration decompression+transpedicle interbody bone grafting in the treatment of thoracolumbar burst fracture.Methods Twenty-eight cases of fresh thoracolumbar burst fractures were subjected to the treatment of posterior transpedicular screw internal fixation+vertebral lamina fenestration decompression+transpedicle interbody bone grafting.Results Postoperative vertebral body height and the physiological radian recovered satisfactorily.After a follow-up period of 18 months,there was no significant loss of vertebral height,no vertebral collapse deformation,and no internal fixation loosening and breaking.Conclusion Posterior transpedicular screw internal fixation plus percutaneous fenestration decompression reduction with percutaneous transpedicular vertebral body bone graft in the treatment of thoracolumbar burst fracture is safe and satisfactory.There is low incidence of postoperative complications and good long-term stability of the spine.