后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗中的效果观察

宋志会　陈进　陈思

[摘要]目的 探討后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗中的效果。方法 选取本院2014年1月～2016年1月收治的40例胸腰椎骨折患者作为研究对象，根据治疗方法的不同分为A组和B组，各20例。A组予以常规内固定后外侧植骨，B组予以经椎弓根椎体植骨疗法。比较两组术前、术后3个月及术后12个月的伤椎Cobb角、椎体前和椎体后缘高度压缩率以及术后3个月骨折预后情况及并发症发生率。结果 B组术后3、12个月的伤椎Cobb角、椎体前缘高度压缩率、椎体后缘高度压缩率均优于A组，差异有统计学意义（P<0.05）。B组术后3个月的VAS评分低于A组，差异有统计学意义（P<0.05）。B组术后3个月的愈合率高于A组，并发症发生率低于A组，差异有统计学意义（P<0.05）。结论 予以胸腰椎骨折患者后路内固定及经椎弓根椎体植骨疗法可改善患者术后的Cobb角，降低椎体前后缘高度压缩率，提高术后愈合率，降低术后并发症，其效果显著，值得临床推广应用。

[关键词]胸腰椎骨折；后路内固定；经椎弓根椎体植骨疗法；伤椎Cobb角

[中图分类号] R683.2 [文献标识码] A [文章编号] 1674-4721（2017）06（a）-0089-03

[Abstract]Objective To explore the effect of posterior internal fixation and transpedicular vertebral bone grafting in the treatment of thoracolumbar vertebral fracture.Methods 40 patients with thoracolumbar vertebral fracture treated in our hospital from January 2014 to January 2016 were selected and divided into group A and group B according to different treatment methods，20 cases in each group.Patients in group A were given routine internal fixation and posterior lateral bone grafting，and patients in group B were given transpedicular vertebral bone grafting.The Cobb angle of the injured vertebra，the height compression ratio of the front and back edges of the vertebral body before operation，3 months and 12 months after operation，and prognosis of fracture after three months of operation and incidence rate of complications in the two groups were compared.Results The Cobb angle，the height compression ratio of the front and back edges of the vertebral body at 3 months and 12 months after operation in group B was better than that in group A，with significant difference （P<0.05）.The VAS score at 3 months after operation in group B was lower than that in group A，with significant difference （P<0.05）.The healing rate of group B at 3 months after operation was higher than that of group A，and the incidence rate of complication in group B was lower than that in group A，with significant difference （P<0.05）.Conclusion Application of posterior internal fixation and transpedicular vertebral bone grafting in the treatment of thoracolumbar vertebral fracture has significant effect，which can promote the Cobb angle of patients after operation，reduce the height compression rate of the front and back edges of the vertebral body，improve healing rate，and decrease the incidence rate of complications，it is worthy of clinical promotion and application.

[Key words]Thoracolumbar vertebral fracture；Posterior internal fixation；Transpedicular vertebral bone grafting；Injured vertebra Cobb angle

胸腰椎骨折为临床中常见骨科疾病，患者常见脊柱损伤[1]，交通事故、高空坠落等外力影响为其主要致病因素，患者多伴有剧烈疼痛，对其生活质量造成严重影响[2]。后路短节段内固定外侧植骨融合术被广泛应用于骨外科，但术后易产生复位丢失或迟发性后凸畸形。本研究选取我院收治的胸腰椎骨折患者作为研究对象，予以不同治疗方案进行干预，并将其治疗效果进行对比，旨在探讨后路内固定及经椎弓根椎体植骨疗法在胸腰椎骨折治疗中的效果，现报道如下。

1资料与方法

1.1一般资料

选取我院2014年1月～2016年1月收治的40例胸腰椎骨折患者作为研究对象。纳入标准：①确诊为胸腰椎爆裂型骨折的患者；②年龄为25～55岁；③无手术禁忌的患者；④无凝血功能障碍的患者；……