CAJ | 학술논문

目的：探讨经伤椎置入螺钉结合经椎弓根植骨治疗胸腰椎骨折的临床疗效。方法对42例胸腰椎骨折实施经伤椎椎弓根钉固定结合经椎弓根植骨术治疗，术前伤椎前缘高度比平均36％，脊柱后凸角（ Cobb角）25°，椎管正中矢状径60％，神经功能按Frankel分级：A级2例，B级9例，C级11例，D级10例，E级10例。结果术后随访6～30个月，42例患者术后疼痛明显缓解，术后伤椎前缘平均高度比恢复到95％，脊柱后凸角（ Cobb角）为3．5°，椎管正中矢状径恢复到96％，手术前后差异显著（P＜0．05）。术后神经功能恢复情况：A级1例，B级4例，C级4例，D级5例，E级28例。术后骨折均获得复位，无一例发生内固定断裂、松动，矫正丢失等并发症。结论经伤椎椎弓根钉固定结合经椎弓根植骨术能让骨折获得满意复位，重建椎体高度，增强脊柱的抗压稳定性，减少内固定断裂和椎体高度丢失等并发症，是一种治疗胸腰椎骨折的有效方法。
목적：탐토경상추치입라정결합경추궁근식골치료흉요추골절적림상료효。방법대42례흉요추골절실시경상추추궁근정고정결합경추궁근식골술치료，술전상추전연고도비평균36％，척주후철각（ Cobb각）25°，추관정중시상경60％，신경공능안Frankel분급：A급2례，B급9례，C급11례，D급10례，E급10례。결과술후수방6～30개월，42례환자술후동통명현완해，술후상추전연평균고도비회복도95％，척주후철각（ Cobb각）위3．5°，추관정중시상경회복도96％，수술전후차이현저（P＜0．05）。술후신경공능회복정황：A급1례，B급4례，C급4례，D급5례，E급28례。술후골절균획득복위，무일례발생내고정단렬、송동，교정주실등병발증。결론경상추추궁근정고정결합경추궁근식골술능양골절획득만의복위，중건추체고도，증강척주적항압은정성，감소내고정단렬화추체고도주실등병발증，시일충치료흉요추골절적유효방법。
To investigate curative effect for thoracolumbar fractures by the method of vertebral pedicle screw fixation with transpedicular bone graft ,and consider its indications.Methods A total of 42 cases of thoracolumbar burst fractures were treated by vertebral pedicle screw fixation combining transpedicular bone graft .The average percent of anterior vertebral height was 36%before the operation, the average of Cobb’ s angle was 25°,the percentage of mid-sagital diameter was 60%.According to Frankel’s neurological function classification, preoperative neurological function was Grade A in 2 cases, B in 9 cases, C in 11 cases, D in 10 cases and E in 10 cases.Results All cases were followed up for 6 to 30 months.All patients’ pain relieved distinctly, the average percent of anterior vertebral height was increased to 95%, the average of Cobb’s angle was 3.5°, the per-centage of midsagital diameter was 96%postoperatively, showing significant differences(P<0.05)before and after operation.The postoperative neurological function was improved:Grade A in 1 case, Grade B in 4 cases, Grade C in 4 cases, Grade D in 5 cases, Grade E in 28 cases.All the fractures were reduced and the internal fixation didn’t loose and break, and there no lost of correction and other complications.Conclusion Vertebral pedicle screw fixation with transpedicular bone graft can not only reduce verbebral fracture satisfactorily, increasing the stability of spine, but also decrease the possibility of breaking nail and correction loss .There-fore it is an effective method of treating thoracolumbar burst fractures .