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1、后路减压-经伤椎椎弓根局部自体骨植骨治疗胸腰段脊柱脊髓损伤【摘要】目的总结后入路减压同时经伤椎椎弓根向伤椎椎体内植骨,行椎弓根钉-棒系统内固定治疗胸、腰腰段脊柱脊髓损伤的疗效。方法后入路经伤椎弓根向伤椎椎体内植骨,同时行椎管环形或次环形减压、短节段或长节段椎弓根钉-棒系统内固定治疗胸、腰椎爆裂骨折83例,其中59例获得随访。术前及随访时行X线和CT检查,测量伤椎椎体中央高度值,比较术后椎体高度的恢复程度,同时观察植骨融合情况。采用配对t检验方法进行统计学分析。结果全部病例均无植骨操作所致的神经血管损伤并发症,无感染。CT检查显示椎体内植骨块融合良好,术后平均随访24.5个
2、月,伤椎椎体中央高度值[T12(3.07±0.34)cm,L1(3.19±0.35)cm]与正常值[T12(3.21±0.35)cm,L1(3.35±0.50)cm]比较,无显著性差异(P>0.05)。结论后路行椎管减压及内固定的同时,经伤椎椎弓根向椎体内植骨,能够达到恢复伤椎椎体高度,重建损伤阶段的前、中柱的稳定性,也能预防术后远期发生椎体塌陷。局部自体骨取材方便,较异体骨费用低廉,较取髂骨并发症少有一定优越性。【关键词】胸腰椎骨折;椎弓根;植骨;减压9Intracorporealgraftingtreatmentofthoracolumbarburstfractureb
3、ytranspedicleofvertebralarchTIANXiao-dong,ZHANGTeng-yun,WEIZhen-shan,etal.Departmentofspineandjoint-surgeryoftheFirstHospitalLiaoningbeipiaocity122100,China【Abstract】ObjectiveTostudyandevaluateintraeorporealgraftingtreatmenteffectsandsignificancebytranspedielevertebralarchonthoraeolumbarfr
4、actures.Methods83caseswiththoraeolumbarfracturesweretreatedbyintraeorporealgraftingtranspedielevertebralarchcombinedwithcircumscribeddecompressionandshortsegmentaltranspedielefixation.ThemiddleheightoftheinjuredvertebraewasmeasuredpostoperativelyatCTimageandanalyzedbypairedStudent~ttestatm
5、anydiferenttimeoffollow-up.ResultsTherewere59caseshadbeenfollowed-upandThefollowed-uptimewas24.5monthsinaverage.Therewasnoinfectionandnoneurologicalandvascularcomplicationscorrelatedwiththistechniqueandinstruments.Theshapeandtheheight9ofinjuredvertebraeweremaintained,andthefusionofgrafting
6、bonewasobserved.Nosignificantdiferencewasfoundinmiddleheightoftheinjuredvertebrae[Tl2(3.07±0.34)cm,Ll(3.19±0.35)cm]comparedwiththatofthenormal[Tl2(3.21±0.35)cm,Ll(3.35±0.50)cm](P>0.05).ConclusionIntraeorporealgraftingbytranspedieleofvertebralarchcombinedwithdecompressionandfixationisoneoft
7、hetreatmentsofthoraeolumbarburstfracturestopreventvertebraebodysubsidepostoperatively.【Keywords】Thoraeolumbarfracture;Pedieleofvertebralarch;Bonegrafting;Decompression作者单位:122100辽宁省北票市第一人民医院脊柱关节外科9随着我国工农业、建筑及交通业发展,城市化步伐的加快,脊柱骨折、脊髓损伤患者数量不断增多,胸腰段脊柱的功能解剖特点决定了该段椎体
