经皮伤椎植骨及椎弓根螺钉内固定术治疗胸腰椎骨折椎体中央高度恢复的临床观察

doi:10.13418/j.issn.1001-165x.2024.6.14

中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (6): 690-694.doi: 10.13418/j.issn.1001-165x.2024.6.14

经皮伤椎植骨及椎弓根螺钉内固定术治疗胸腰椎骨折椎体中央高度恢复的临床观察

任涛，瞿东滨，郑明辉，马洋洋，陈永和，李建龙*

南方医科大学南方医院增城院区骨科，广东广州 511330；南方医科大学南方医院关节与骨病外科，广东广州 510515

收稿日期:2024-05-09 出版日期:2024-11-25 发布日期:2024-12-16
通讯作者: 李建龙，医学博士，主治医师，E-mail：jianlongyx@163.com
作者简介:任涛（1981-），男，黑龙江牡丹江人，副主任医师，主要研究方向为脊柱骨科，E-mail:nfyyrt@163.com
基金资助:
广东省基础与应用基础研究基金（2414070000454）；南方医科大学南方医院院长基金（2023A031）

Clinical observation of vertebral height after percutaneous bone grafting and pedicle screw fixation for thoracolumbar vertebral fracture

Ren Tao, Qu Dongbin, Zheng Minghui, Ma Yangyang, Chen Yonghe, Li Jianlong*

Department of Orthopedics, Zengcheng Campus, Nanfang Hospital, Southern Medical University, Guangzhou 511330; Joint and Osteopathic Surgery，Nanfang Hospital, Southern Medical University, Guangzhou 510515

Received:2024-05-09 Online:2024-11-25 Published:2024-12-16

摘要/Abstract

摘要： 目的探讨经皮伤椎植骨、椎弓根螺钉内固定术对胸腰椎骨折椎体中央高度恢复的影响及其临床观察。方法 2014年1月至2019年12月我院收治的单节段胸腰椎骨折患者89例，所有患者为T11~L2单椎体骨折(AO分型为A型)。患者依据椎弓根螺钉固定方式不同分为经伤椎固定植骨组(n=15)、经伤椎固定组(n=58)、跨伤椎固定组(n=16)。测量术前、术后伤椎椎体前缘高度(Ha)、椎体中央高度(Hm)、椎体后缘高度(Hp)及后凸Cobb角,统计分析末次随访Ha丢失率、Hm丢失率及后凸Cobb角丢失率,观察3组治疗后椎体高度及后凸角度的恢复情况。结果 89例患者术后及末次随访Ha压缩率、Hm压缩率及Cobb角均较术前有明显改善，具有显著差异(P<0.05)；末次随访中，经伤椎固定植骨组Hm丢失率（7.73±5.26）%及经伤椎固定组Hm丢失率（11.71±11.15）%均较跨伤椎固定组Hm丢失率（19.81±8.50）%低，有显著意义(P<0.05)。经伤椎固定植骨组较单纯经伤椎固定组Hm丢失率低，两者比较具有近似性统计学差异（P=0.052）。结论经皮椎弓根螺钉内固定治疗胸腰椎骨折可促进骨折椎体前缘及中央高度的恢复，经伤椎植骨椎弓根螺钉内固定术联合椎体内植骨更有效的防止术后伤椎中央高度的丢失。

关键词: 胸腰椎骨折； , , 骨折分型； , , 椎体中央高度； , , 伤椎置钉； , , 经椎弓根植骨

Abstract: Objective To investigate the effect of bone grafting and pedicle screw internal fixation on the recovery of central vertebral height after thoracolumbar fracture and its clinical observation. Methods From January 2012 to December 2019, 89 patients with single-segment thoracolumbar fracture were admitted to our hospital, all of whom had single vertebral fracture T11~L2 (AO type A). Patients were divided into 3 groups according to different treatment methods: a trans-injured vertebra fixation and bone grafting group (n=15), a trans-injured vertebra fixation group (n=58), and a cross injury vertebral fixation group (n=16). The anterior vertebral body height (Ha), central vertebral body height (Hm), posterior vertebral body height (Hp) and kyphosis Cobb Angle of the injured vertebra were measured. The Ha loss rate, Hm loss rate and kyphosis Cobb Angle loss rate were statistically compared and analyzed in the last follow-up, and the recovery of vertebral height and kyphosis Angle after treatment was observed. Results The Ha compression rate, Hm compression rate and Cobb Angle of 89 patients after operation and at the last follow-up were significantly improved compared with those before operation, with significant differences (P<0.05). However, in the last follow-up, Hm loss rate (7.73±5.26) % in the trans-injured vertebra fixation and bone grafting group and Hm loss rate (11.71±11.15) % in the trans-injured vertebra fixation group were both lower than that in the cross injury vertebral fixation group (19.81±8.50) %, with significant significance (P<0.05). Hm loss rate in the trans-injured vertebra fixation and bone grafting group was lower than that in the simple injured vertebra fixation group, and there was similar statistical difference between them (P=0.052). Conclusions Percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures can promote the recovery of the anterior and central height of the fractured vertebra, and the injured vertebral bone graft pedicle screw internal fixation in combination with vertebral body bone graft is more effective to prevent the loss of the central height of the injured vertebra

Key words: Thoracolumbar fracture; , , Fracture type; , Central height of vertebral body; , Screw placement for injured vertebra; , , Bone graft through vertebral arch

中图分类号:

R681.5

任涛, 瞿东滨, 郑明辉, 马洋洋, 陈永和, 李建龙. 经皮伤椎植骨及椎弓根螺钉内固定术治疗胸腰椎骨折椎体中央高度恢复的临床观察[J]. 中国临床解剖学杂志, 2024, 42(6): 690-694.

Ren Tao, Qu Dongbin, Zheng Minghui, Ma Yangyang, Chen Yonghe, Li Jianlong. Clinical observation of vertebral height after percutaneous bone grafting and pedicle screw fixation for thoracolumbar vertebral fracture[J]. Chinese Journal of Clinical Anatomy, 2024, 42(6): 690-694.

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经皮伤椎植骨及椎弓根螺钉内固定术治疗胸腰椎骨折椎体中央高度恢复的临床观察

Clinical observation of vertebral height after percutaneous bone grafting and pedicle screw fixation for thoracolumbar vertebral fracture

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