CAJ | 학술논문

目的探讨采用经伤椎椎弓根椎体内异体骨粒打压植骨预防胸腰段骨质疏松性压缩骨折术后伤椎椎体塌陷的临床疗效. 方法采用后路短节段椎弓根钉复位固定结合经椎弓根行伤椎椎体内异体骨粒移植治疗胸腰段骨质疏松性压缩骨折45例,术前、术后及随访期间拍摄正、侧位X线片,测定伤椎椎体前缘及中央高度压缩百分比、椎体成角及上下终板成角,评价局部胸背痛变化情况,了解骨折复位术后随访期有无内固定失败及矫形丢失情况. 结果通过手术复位及椎体内植骨,术后疼痛缓解明显,椎体高度、椎体成角及上下终板成角均明显改善;平均随访2年以上的38例患者中34例胸背疼痛完全解除,所有患者影像学测量结果与术后相比无明显变化,无一例发生内固定失败.结论采用后路短节段椎弓根钉复位固定结合经伤椎椎弓根椎体内异种骨粒打压植骨治疗胸腰段骨质疏松性压缩骨折可有效矫正局部畸形,预防伤椎椎体塌陷及内固定失败,临床疗效良好,是一种较理想的治疗手段.
목적 탐토채용경상추추궁근추체내이체골립타압식골예방흉요단골질소송성압축골절술후상추추체탑함적림상료효. 방법채용후로단절단추궁근정복위고정결합경추궁근행상추추체내이체골립이식치료흉요단골질소송성압축골절45례,술전、술후급수방기간박섭정、측위X선편,측정상추추체전연급중앙고도압축백분비、추체성각급상하종판성각,평개국부흉배통변화정황,료해골절복위술후수방기유무내고정실패급교형주실정황. 결과통과수술복위급추체내식골,술후동통완해명현,추체고도、추체성각급상하종판성각균명현개선;평균수방2년이상적38례환자중34례흉배동통완전해제,소유환자영상학측량결과여술후상비무명현변화,무일례발생내고정실패.결론 채용후로단절단추궁근정복위고정결합경상추추궁근추체내이충골립타압식골치료흉요단골질소송성압축골절가유효교정국부기형,예방상추추체탑함급내고정실패,림상료효량호,시일충교이상적치료수단.
Objective To evaluate the clinical efficacy of transpedicular intracorporeal bone graft with allogenic bone in treatment of thoracolumbar osteoporotic compression fracture. Methods A total of 45 patients with thoracolumbar osteoporotic compression fractures were treated with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone. Anteroposte-rior and lateral X-ray photographs were taken before and after operation and at follow up period to determine the ratio of anterior and middle compressed body height to the normal height, the vertebral angle and the superior-inferior endplate angle. The extent of local pain was measured by VAS score. The implant failure was also recorded during follow-up. Results The operative reduction and interbody bone grafting exerted a satisfactory effect on the ratio of anterior and middle body height to the normal height, the vertebral angle and the superior-inferior endplate angle. Local back pain disappeared immediately after surgery in 34 patients out of 38 patients followed up for more than two years. No implant failure was found during follow-up. Conclusions Early treatment with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone can effectively correct local deformity, prevent late vertebral collapse and implant failure and is an ideal treatment method for thoracolumbar osteoporotic compression fracture.