微创医学

目的探讨后路伤椎置短椎弓根螺钉技术治疗胸腰椎爆裂性骨折的可行性及临床意义。方法选择施行后路伤椎置短椎弓根螺钉技术治疗胸腰椎爆裂性骨折的患者88例，以纠正伤椎的后凸畸形和移位，对所有患者进行随访，随访时间2个月～37个月，术前术后Denis腰痛分级，定期复查脊柱正侧位X光片，观察其疗效。结果术前伤椎椎体压缩率（55.1±10.2）%，Cobb角（17.0±7.8）。术后6个月伤椎椎体压缩率（15.5±5.9）%，Cobb角（5.5±6.1）；术后1年伤椎椎体压缩率（19.3±7.7）%，Cobb角（7.2±5.3）；术后18个月伤椎椎体压缩率（20.5±8.7）%，Cobb角（8.5±5.4）。手术前后伤椎椎体压缩率和Cobb角比较，差异均有统计学意义（P＜0.05）。结论后路伤椎置短椎弓根螺钉技术治疗胸腰椎爆裂性骨折，有利于骨折复位和骨折的愈合，改善固定强度，防止断钉和脱钉的发生。

ObjectiveTo investigate the technical feasibility and clinical significance of short pedicle screws fixation via posterior fractured vertebral approach in the trea tment of thoracolumbar burst fractures. MethodsFrom March 2009-2012, 88 cases with thoracolumbar burst fractures were treated by short pedicle screws fixation via posterior fractured vertebral approach to correct the fractured vertebral kyphosis and displacement.The follow up period ranged from 2 months to 37 months, with an average of 18.4 months. The contents of the followup included preoperative and postoperative Denis lumbago grading, the AP view geometry and lateral view geometry XRay spine examination. ResultsThe preoperative ratio of injury vertebra compression was 55.1±10.2%, with the Cobb angle of 17.0±7.8. the ratio of vertebra compression six months after treatment was 15.5±5.9%, with the Cobb angle of 5.5±6.1; the ratio of vertebra compression 1 year after after treatment was 19.3±7.7%, Cobb angle (7.2±5.3) after 18 months of injury vertebral compression ratio (20.5±8.7)%, with the Cobb angle of 8.5 ± 5.4. There were significant differences in the ratio of vertebra compression and the Cobb angl e before and after treatment (P＜0.05). ConclusionsShort pedicle screws fixation via posterior fractured vertebral approach in the treatment of thoracolumbar burst fractures can promote the healing of fractures, improve the fixation strength, prevent nail fracture and migration.