摘要
目的总结经椎弓根伤椎内植骨治疗胸腰椎爆裂骨折方法,规范术中操作要点,使其更加安全有效.方法 60例胸腰椎爆裂骨折后路钉棒复位,经椎弓根伤椎内植入自体髂骨、异体人工骨、磷酸钙人工骨或带BMP人工骨粒,4例经球囊扩张处理椎体,术后随访行X片和CT检查了解植骨情况.结果 60例均未发生钉棒断裂,2例椎体仍存空腔,2例出现继发性椎管占位,但无神经损伤症状,4例球囊处理后椎体植骨充实.结论胸腰椎爆裂骨折经椎弓根伤椎植骨技术中,后路钉棒可以良好复位伤椎高度和椎管减压的病例,需采用工作套管操作,注意通道方向需朝向骨折线处,套管开口方向需朝向中线,可以植入不同的替代材料,应用球囊可以使植骨充实.
Objective To sum up the clinical experience in the treatment of thoracolumbar burst fracture with transpedicular bone grafting,and to establish the specification of procedure in order to improve the safety and efficacy of the operation.Methods Transpedicular bone(autogenous,allogenic,artificial calcium acid phosphate bone,artificial bone with BMP)grafting after reduction and fixation was given 60 cases of thoracolumbar burst fracture via posterior approach.X-ray and CT were performed post-operation.Results Rod-broken was not found in all cases.The cavities were remained in two cases.The grafting bones were detected in the spinal canal in two cases.Fortunately,there was no symptoms of nerve injury.Four cases,the balloons were utilized to enlarge the cavity,were repletion of grafting bone.Conclusions In the treatment of thoracolumbar burst fracture with transpedicular bone grafting,we should pay attention to the following details:The cases,the height and the back edge of vertebral body can be performed reduction perfectly,can be choosed to perform the operation;we advocate to use the cannula with debouch of 30 degrees;To control the cannula towards the cavity and the debouch towards the middle of vertebral body;The balloon for PKP is the better choice if the economic status of patient is permitted.
出处
《昆明医学院学报》
2011年第12期118-121,共4页
Journal of Kunming Medical College
关键词
胸腰椎爆裂骨折
经椎弓根
植骨
Thoracolumbar burst fracture
Transpedicular
Bone grafting
