目的 椎弓根钉系统固定结合经椎弓根自体骨移植治疗胸腰椎爆裂性骨折的疗效分析.方法 选择35例胸腰椎爆裂性骨折病例,采用椎弓根钉系统固定结合经椎弓根自体骨移植治疗,术后卧床2～3周后,在支具保护下可下地活动,3～4个月后去支具活动,骨折愈合后取出内固定,随访30个月.结果 术后3d及至随访结束时,伤椎前、后缘与正常的高度比与术前相比,差异有统计学意义(P＜0.01),术后3d与随访结束时比较,差异无统计学意义；术后3d及随访结束时Cobb后凸角的矫正效果比较,差异有统计学意义(P＜0.01).结论 椎弓根钉系统固定可在骨折早期起支撑及固定作用,脊柱的长期稳定有赖于椎体自身的生物力学稳定的建立；对胸腰椎爆裂性骨折患者进行植骨选择伤椎椎弓根椎体内植骨,可达到恢复正常脊柱序列和重建脊柱稳定性的目的.%Objective Efficacy of pedicle screw fixation combined with autogenous bone graft by the pedicle treating tho-racolumbar burst fracture. Methods Select 35 cases of thoracolumbar burst fracture were using pedicle screw fixation combined with autogenous bone graft by the pedicle to treat thoracolumbar burst fractures, After 2 to 3 weeks in bed, under the protection of the brace may ambulation. 3 ～4 months to brace activities, Remove the internal fixation after fracture healing,follow-up 30 months. Results After 3 days and the end of follow-up, vertebral injury front, the height of the trailing edge than normal compared with the preoperative was significanttly (P ＜0. 01). 3 days after surgery compared with the end of follow-up was no significant difference. Cobb angle correction of kyphosis had an significant effect on 3 days after surgery and the end of follow-up ( P ＜ 0. 01). Conclusion Pedicle screw fixation in fractures fixed has a role of early support, the of long-term stability, depends on the vertebrae of the spine biomechanical stability of its establishment; Treating patients of thoracolumbar burst fractures with vertebral pedicle bone graft should be selected vertebral vivo graft, can achieve normal spine series and the purpose of reconstruction of spinal stability.
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