经伤椎椎弓根植骨内固定技术在胸腰椎爆裂骨折中的应用

【目的】探讨经伤椎椎弓根植骨内固定非融合技术治疗胸腰段爆裂骨折的临床疗效。【方法】回顾性分析2010年7月至2012年7月保定市第二中心医院胸腰椎爆裂骨折患者198例，所有患者均接受后路短节段内固定手术治疗，未行椎体间融合，其中试验组84例为伤椎单侧置钉加伤椎内植骨，对照组114例伤椎未植入椎弓根钉未行伤椎内植骨，术后随访，比较两组间手术时间、出血量、术后及末次随访时椎体前后缘高度比、后凸cobb角、断钉率、疼痛VAS评分。【结果】两组手术时间及出血量、术后椎体高度及Cobb角比较差异无显著性（ P＜0．05），末次随访时试验组Cobb角和椎体高度、VAS疼痛评分优于对照组。内固定失败均为断钉发生，试验组断钉发生率（3．6％）低于对照组（11．4％），差异具有统计学意义（P ＜0．05）。【结论】经伤椎椎弓根植骨内固定的非融合技术可降低胸腰椎爆裂骨折内固定失败发生率，有助于改善术后远期预后。

Application of Bone Graft with Internal Fixation Technology via Wounded Vertebral Pedicle in Thoracolumbar Burst Fracture

Objective] To explore the clinical efficacy of bone graft with internal fixation non-fusion technology via wounded vertebral pedicle for the treatment of thoracolumbar burst fracture .Methods]Totally 198 patients with thoracolumbar burst fracture in the second central hospital of Baoding city from July 2010 to July 2012 were analyzed retrospectively .All patients underwent posterior short segment internal fixation without interbody fusion .Among them ,the experiment group（ n=84） underwent screw fixation in unilateral injured vertebra combined with bone graft in injured vertebra .The control group（ n=114） did not underwent pedicle screw fixation and bone graft in injured vertebra .The patients were postoperatively followed up .The operation time ,blood loss ,the ratio of anterior edge height to posterior edge height of vertebra body ,Cobb angle ,screw breakage rate ,VAS pain score after operation and at the last time of follow up were compared between two groups .Results]There was no significant difference in operation time ,blood loss ,postoperative height of vertebral body and Cobb angle between two groups （ P 〉0 .05） . Cobb angle ,the height of vertebral body and VAS pain score in experiment group at the last time of follow up were better than those in control group .In this study ,internal fixation failure was caused by broken screw .The incidence of broken screw in experiment group was lower than that in control group ,and there was significant difference （ P〈0 .05） .Conclusion]Bone graft with internal fixation non-fusion technology via injured vertebra can reduce the inci-dence rate of internal fixation failure in thoracolumbar burst fracture ,and is helpful for improving the long-term prog-nosis after surgery .