Effect of pedicle screw fixation combined with transpedicular intracorporeal grafting on restoration of vertebral height in patients with thoracolumbar fractures

Chuanli ZHONG; Xuan WENG; Bin PANG; Feng ZHOU; Yongsheng CHENG; Xun LIU; Fei LUO

doi:10.16016/j.1000-5404.201706020

您当前的位置：

首页 >

文章列表页 >

Effect of pedicle screw fixation combined with transpedicular intracorporeal grafting on restoration of vertebral height in patients with thoracolumbar fractures

Clinical Medicine | 更新时间：2026-01-09

- Effect of pedicle screw fixation combined with transpedicular intracorporeal grafting on restoration of vertebral height in patients with thoracolumbar fractures
- Journal of Third Military Medical University Vol. 39, Issue 15, Pages: 1582-1585(2017)
- 作者机构：
  
  1.404000 重庆，重庆市渝北区人民医院骨二科
  2.400038 重庆，第三军医大学西南医院骨科，全军矫形外科中心
- 作者简介：
- 基金信息：
  
  the Clinical Innovative Fund of Southwest Hospital of Third Military Medical University(SWH2013LC15)
- DOI：10.16016/j.1000-5404.201706020
  CLC： R181.32;R683.2;R687.3
- Received：04 June 2017，
  
  Revised：2017-07-04，
  
  Published：15 August 2017
- 稿件说明：
移动端阅览
Chuanli ZHONG, Xuan WENG, Bin PANG, et al. Effect of pedicle screw fixation combined with transpedicular intracorporeal grafting on restoration of vertebral height in patients with thoracolumbar fractures[J]. Journal of Third Military Medical University, 2017, 39(15): 1582-1585.
DOI：

Chuanli ZHONG, Xuan WENG, Bin PANG, et al. Effect of pedicle screw fixation combined with transpedicular intracorporeal grafting on restoration of vertebral height in patients with thoracolumbar fractures[J]. Journal of Third Military Medical University, 2017, 39(15): 1582-1585. DOI： 10.16016/j.1000-5404.201706020.

摘要

目的

探讨经后路椎弓根钉内固定联合经伤椎椎弓根植骨治疗胸腰椎骨折的临床疗效。

方法

筛选第三军医大学西南医院骨科和重庆市渝北区人民医院骨科2010年1月至2016年12月收治的426例胸腰椎骨折患者，按照不同手术方式分为：观察组(

=118)，采用经伤椎椎弓根进行椎体植同种异体骨+后路GSS-Ⅳ型脊柱通用内固定系统固定；对照组(

=308)，单纯使用后路GSS-Ⅳ型脊柱通用内固定系统进行治疗。回顾性分析两组患者手术前后功能疼痛视觉模拟评分(VAS评分)、伤椎前缘高度比值、Cobb角改变及其并发症发生率。

结果

① 两组手术前后伤椎前缘高度比值、Cobb角改变、VAS评分等比较，差异均具有统计学意义(

＜0.05)。② 与对照组相比，观察组手术时间差异有统计学意义(

＜0.05)；术中出血量较对照组较多，但差异无统计学意义(

＞0.05)；术后1个月及1年伤椎前缘高度比值、Cobb角改变差异具有统计学意义(

＜0.05)；术后1个月VAS评分差异无统计学意义(

＞0.05)；术后1年VAS评分较低，但差异无统计学意义(

＞0.05)。

结论

经伤椎椎弓根进行植骨可以达到更满意的临床效果，适合临床推广使用。

Abstract

Objective

To investigate the clinical efficacy of posterior pedicle screw internal fixation and transpedicular intracorporeal bone grafting in the treatment of thoracolumbar fractures.

Methods

A total of 426 patients with thoracic and lumbar fractures admitted in People's Hospital of Yubei District and Southwest Hospital from January 2010 to December 2016 were recruited in this study. They were divided into the observation group (

=118

transpedicular intracorporeal bone allografting with posterior GSS-Ⅳ internal fixation) and control group (

=308

only posterior GSS-Ⅳ internal fixation). Score of visual analogue scale (VAS)

ratio of anterior vertebral height

change of Cobb angle

and the incidence rate of complications were compared before and after the treatment

and between the 2 groups.

Results

① Significant differences were seen in the ratio of anterior vertebral height

change of Cobb angle and VAS score before and after the treatment in both groups (

0.05). ② Compared with the control group

the observation group had significantly shorter operation time

(

0.05)

better results in anterior vertebral height ratio and Cobb angle changes (

0.05)

larger intra-operative blood loss but without statistical difference (

0.05)

no difference in VAS score in 1 month after operation (

0.05)

and lower VAS score in 1 year after operation though still no notable difference (

0.05).

Conclusion

Transpedicular bone grafting obtains sound outcomes in treatment of thoracolumbar fractures

and is worthy of promotion in clinical practice.

关键词

Keywords

references

CHEN C, LV G, XU B, et al . Posterior short-segment instrumentation and limited segmental decompression supplemented with vertebroplasty with calcium sulphate and intermediate screws for thoracolumbar burst fractures[J ] . Eur Spine J, 2014, 23(7): 1548-1557. DOI:10.1007/s00586-014-3374-z.

[LIAO J C, FAN K F, KEOROCHANA G, et al . Transpedicular grafting after short-segment pedicle instrumentation for thoracolumbar burst fracture: calcium sulfate cement versus autogenous iliac bone graft[Z ] . 2010: 35, 1482-1488. DOI: 10.1097/BRS.0b013e3181c176f8. http://dx.doi.org/10.1097/BRS.0b013e3181c176f8. .

ALANAY A, ACAROGLU E, YAZICI M, et al . Short-segment pedicle instrumentation of thoracolumbar burst fractures: does transpedicular intracorporeal grafting prevent early failure?[J ] . Spine (Phila Pa 1976), 2001, 26(2): 213-217. DOI:10.1097/00007632-200101150-00017.

黎高明, 唐德志.后路短节段椎弓根钉结合经椎弓根植骨治疗胸腰椎爆裂性骨折[J].中国骨伤, 2015, 28(1): 8-11.

LI G M, TANG D Z. Short-segment posterior pedicle screw combined with vertebral arch bone wafting for thoracolumbar burst fractures[J]. Chin J Orthopae Traumatol, 2015, 28(1):8-11.DOI: 10.3969/j.issn.1003-0034.2015.01.003.

王向阳, 戴力扬, 徐华梓, 等.胸腰椎不同程度前中柱骨折内固定后的生物力学特征及前路重建的意义[J].中华创伤杂志, 2006, 22(3): 214-217.

WANG X Y, DAI L Y, XU H Z, et al . Biomechanic character and anterior reconstruction significance posterior to internal fixation of various extents of anterior median spine fractures of thoracolumbar vertebrae[J ] . Chin J Trauma, 2006, 22(3): 214-217.DOI: 10.3760/j:issn:1001-8050.2006.03.015.

STULIK J, KRBEC M, VYSKOCIL T. Use of bioceramics in the treatment of fractures of the thoraco-lumbar spine[J]. Acta Chir Orthop Traumatol Cech, 2002, 69(5): 288-294.

陈农, 周海林, 周凯华, 等.后路短节段固定结合经伤椎椎弓根植骨治疗胸腰椎骨折[J].中国临床医学. 2016, 23(1): 48-52.

CHEN N, ZHOU H L, ZHOU K H, et al . Posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafting in treatment of thoracolumbar fractures[J ] . Clin Med J Chin, 2016, 23(1): 48-52.

ONER F C, VERLAAN J J, VERBOUT A J, et al . Cement augmentation techniques in traumatic thoracolumbar spine fractures[J ] . Spine (Phila Pa 1976), 2006, 31(11 Suppl): S89-S95, S104. DOI:10.1097/01.brs.0000217950.60516.e6.

LEFERINK V J, ZIMMERMAN K W, VELDHUIS E F, et al . Thoracolumbar spinal fractures: radiological results of transpedicular fixation combined with transpedicular cancellous bone graft and posterior fusion in 183 patients[J ] . Eur Spine J, 2001, 10(6): 517-523.DOI:10.1007/s005860100319.

KATSCHER S, VERHEYDEN P, GONSCHOREK O, et al . Thoracolumbar spine fractures after conservative and surgical treatment. Dependence of correction loss on fracture level[J ] . Unfallchirurg, 2003, 106(1): 20-27. DOI:10.1007/s00113-002-0459-7.

张贵林, 李楠, 公茂琪, 等.中老年人脊柱胸腰段爆裂型骨折采用椎弓根系统治疗的特点[J].中华骨科杂志, 2002, 22(12): 727-731.

ZHANG G L, LI N, GONG M Q, et al . Characteristics of pedicle screw fixation for thoracolumbar burst fractures among middle and old aged patients[J ] . Chin J Orthop, 2002, 22(12): 727-731. DOI: 10.3760/j.issn:0253-2352.2002.12.006.

杨操, 杨述华, 王洪, 等. USS复位内固定结合经椎弓根植骨治疗胸腰椎爆裂性骨折[J].中华创伤骨科杂志, 2005, 7(6): 537-540.

YANG C, YANG S H, WANG H, et al . Treatment of thoracolumbar burst fracture with uss instrumentation and transpedicular bone grafting[J ] . Chin J Orthop Trauma, 2005, 7(6): 537-540. DOI: 10.3760/cma.j.issn.1671-7600.2005.06.011.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰