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后路短节段内固定经椎弓根液态人工骨植骨治疗胸腰椎骨折的临床应用研究
陈欢欢1, 邢进峰1, 丁伟航1, 汤小康2
1.浙江中医药大学附属第一医院;2.湖南中医药大学附属第一医院
摘要:
目的 分析胸腰椎骨折后路复位短节段内固定经椎弓根Wright 液态人工骨植骨的疗效。方法 38 例胸腰椎骨折患者结合患者的经济能力分为两组,A(未植骨)组24 例单纯行后路切复椎弓根螺钉内固定术,B(植骨)组14 例一期行后路切复椎弓根螺钉内固定并经椎弓根行椎体内Wright 液态人工骨植骨术,分别随访10~27 个月,比较两组患者拆钉时伤椎前缘高度的再压缩率、Cobb角变化及伤椎影像学的变化。结果 B 组患者拆钉时伤椎前缘高度再压缩率为(5.43±2.71)%,术后Cobb 角增大为(2.03±0.51)°,与A 组(6.29±2.24)°相比差异有统计学意义(P<0.05),A 组患者术后不同程度的出现蛋壳样改变,其中2例出现断钉,1例患者出现上位椎弓根钉切割出椎体,而B 组患者未出现明显蛋壳样改变及断钉现象。结论 胸腰椎骨折后路复位短节段椎弓根钉内固定经椎弓根Wright 液态人工骨植骨能明显改善伤椎骨折的愈合,维持椎体的高度,减少蛋壳样改变及断钉等情况的发生。
关键词:  胸腰椎  脊柱骨折  椎弓根螺钉  液态人工骨
DOI:
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基金项目:
Short-segment transpedicular screw internal fixation combined with artificial bone implantation in treatment of thoracolumbar fracture
CHENG Huanhuan,XING Jinfeng,DING Weihuang,TANG Xiaokang
the First Affiliated Hospital of Zhejiang Chinese Medical University
Abstract:
Objective To evaluate the efficacy of short-segment transpedicular screw internal fixation combined with implantation of liquid artificial bone in treatment of thoracolumbar fracture. Methods Thirty eight patients with thoracolumbar fracture were included in the study, including 24 cases treated by short-segment transpedicular screw internal fixation (group A), 14 cases treated by short-segment transpedicular screw internal fixation combined with transpedicular implantation of liquid artificial bone (group B). Patients were followed up for 10~27 month, the changes of anterior height of the fractured vertebra, Cobb's angle and imaging changes were compared between two groups. Results When the fixation were removed, the change of anterior height of the fracture vertebral in group B was (5.43±2.71)%, the change of the Cobb's angle was (2.03± 0.51)°, which were significantly different to those in group A (P<0.05). Two patients in group A had broken transpedicular screws, but no such complications occurred in group B. Conclusion Short-segment transpedicular screw internal fixation combined with implantation of liquid artificial bone is more effective than fixation alone in treatment of patients with thoracolumbar fracture.
Key words:  Thoracolumbar  Spinal fracture  Transpedicular screw  Liquid artificial bone