AF内固定联合经椎弓根注射硫酸钙增强治疗胸腰椎爆裂性骨折

Complex of AF pedicle screw system and injectable calcium sulfate bone graft for thoracolumbar burst fracture

中文关键词:  爆裂骨折  胸椎  腰椎  硫酸钙  骨移植  内固定器

英文关键词:Thoracic  Lumbar vertebrae  Calcium sulfate  Bone transplantation  Spinal fractures  Internal fixa鄄tors.

中文摘要:

  【摘要】 目的：分析AF系统复位内固定联合经椎弓根注射硫酸钙增强治疗胸腰椎爆裂性骨折的临床效果。方法：将2007年12月～2010年12月收治的72例胸腰椎爆裂性骨折患者分为2组：A组（行AF内固定并辅助经椎弓根注射硫酸钙增强）36例，B组（仅行AF内固定）36例，平均随访13个月，术前、术后及末次随访时在X线片上测量两组患者伤椎相对高度、Cobb角及伤椎后凸角，并进行比较分析。结果：伤椎相对高度术前A组为46.7%，B组为48.4%；术后分别为5.7%和5.9%；末次随访时分别为9.4%和19.6%。Cobb角术前A组为20.7°，B组为20.6°；术后分别为2.8°和3.1°；末次随访时分别为6.4°和12.7°。伤椎后凸角术前A组为20.7°，B组为20.5°；术后分别为6.4°和6.8°；末次随访时分别为7.8°和13.8°。手术前后两组间Cobb角、伤椎后凸角及伤椎相对高度差异无统计学意义（P＞0.05），而末次随访时两组间Cobb角、伤椎后凸角及伤椎相对高度差异有统计学意义（P＜0.01）。末次随访时A组中液体硫酸钙均吸收成骨，仅1例螺钉松动；B组5例断钉，1例螺钉松动退出。结论：AF系统复位内固定联合经椎弓根注射硫酸钙增强治疗胸腰椎爆裂性骨折，固定可靠，能减少伤椎高度丢失，减少后凸畸形等并发症的发生。

英文摘要:

  【Abstract】 Objective：To investigate the clinical effects of complex of AF pedicle screw system and injectable calcium sulfate graft for thoracolumbar burst fracture.Method：72 patients with thoracolumbar burst fractures were treated between December 2007 and December 2010，of them，36 cases（group A） underwent the complex of AF pedicle screw system and injectable calcium sulfate bone graft，while 36 cases（group B） underwent AF alone，all cases were followed up for an average of 13 months，the fractured vertebral body height，Cobb′s angle and kyphosis between 2 groups were reviewed and compared.Result：The preoperative fractured vertebral height for group A and B was 46.7% and 48.4%，while those for postoperative was 5.7% and 5.9%，and for final follow-up was 9.4% and 19.6% respectively.The preoperative Cobb′s angle for group A and B was 20.7° and 20.6°，while those for postoperative was 2.8° and 3.1°，and for final follow-up was 6.4°and 12.7° respectively.The preoperative kyphosis for group A and B was 20.7° and 20.5°，while those for postoperative was 6.4° and 6.8°，and for final follow-up was 7.8° and 13.8°.The preoperative and postoperative index between 2 groups showed no significant difference（P＞0.05），while those index at final follow-up between 2 groups showed significant difference（P＜0.01）.At final follow-up，calcium sulfate in group A was noted to induce ossification，screw loosening was noted in 1 case of group A，but there were 6 cases suffered instrument failure in group B（5 cases of screw breaking and 1 case of screw loosening）.Conclusion：Complex of AF pedicle screw system and injectable calcium sulfate bone graft for thoracolumbar burst fracture is reliable and less complication such as kyphosis increasing.