后路椎弓根螺钉内固定结合后外侧植骨融合治疗胸腰椎骨折的临床观察

目的：观察后路椎弓根螺钉内固定结合后外侧植骨融合治疗胸腰椎骨折的临床效果及安全性。方法：回顾性分析2010年6月-2012年4月在我院脊柱骨科住院治疗的71例胸腰脊椎骨折患者，所有患者随机被分成2组，治疗组38例接受采用后路椎弓根螺钉内固定结合后外侧植骨融合治疗，对照组33例接受传统椎弓根螺钉内固定。术后对患者椎体前缘高度、脊柱Cobb’s角、腰背痛、神经功能恢复情况、内固定并发症等方面进行手术效果的评价。结果：治疗组术后及随诊患者的椎体前、后缘高度的比值与对照组相比，均有统计学差异（P〈0．05）；治疗组术后及随诊患者的Cobb’s角较对照组明显减小，差异有统计学意义（P〈0．05），治疗组手术时间与对照组相比差异有统计学意义（P〈0．05）；两组患者医疗费用、神经功能改善筝级相互比较，无统计学意义咿0．05）。结论：后路复位椎弓根螺钉内固定结合后外侧植骨融合治疗胸腰椎骨折的临床疗效确切。

Clinical Observation of Posterior Pedicle Screw Internal Fixation Integrated with Posterolateral Bone Graft Fusion in Treating Thoracolumbar Vertebral Fracture

Objective： To explore the clinical effect and safety of posterior pedicle screw internal fixation integrated with posterolateral bone graft fusion in treating thoracolumbar vertebral fracture. Methods： 71 cases accepting treatment from June 2010 to April 2012 in our hospital were divided randomly into two groups. The control group（n=33） was treated with traditional pedicle screw internal fixati- on, while the treating group （n=38） was treated with posterior pedicle screw internal fixation integrated with posterolateral bone graft fu- sion. After surgery, the height of anterior vertebral body, spinal Cobb＇s Angle, lumbago and backache, neurological function recovery and internal fLxation complications of patients were assessed. Results： Between two groups, the ratio of anterior and posterior vertebral body height after surgery and during follow-up clinic of the treating group showed statistical difference （P〈0.05）; the Cobb＇s angle diminished obviously in treating group after surgery and during follow-up clinic （P〈0.05）; there was statistical difference in operation time between two groups （P〈0.05）; but there was no statistical difference in the medical cost and added value of Frankel grade between two groups （P〉0.05）. Conclusion： The therapeutic effect of posterior pedicle screw internal fixation integrated with posterolateral bone graft fusion is conclusive and convincing in treatment of thoracolumbar vertebral fracture.