Huang Weijie, Luo Tao
Department of Orthopedics, Shanghai Punan Hospital of Pudong New Area, Shanghai 200125, P.R. China.
Exp Ther Med. 2013 Mar;5(3):678-682. doi: 10.3892/etm.2013.914. Epub 2013 Jan 21.
The present study aimed to discuss the method and effect of posterior internal fixation of thoracolumbar fractures strengthened by the vertical stress pedicle screw fixation of fractured vertebrae. Patients with single thoracolumbar fractures were examined retrospectively. Fourteen patients (group A) had been treated with vertical stress pedicle screw fixation of a fractured vertebra and sixteen patients (group B) received traditional double-plate fixation, as a control. All patients were diagnosed with fresh fractures with a complete unilateral or bilateral pedicle and no explosion of the inferior half of the vertebral body or inferior endplate. In group A, patients received conventional posterior distraction and lumbar lordosis restoration, as well as pedicle screws in the fractured vertebra in a vertical direction to relieve stress to achieve a local stress balance. All patients were followed up postoperatively for 4-18 months (average, 12.6 months). The vertical stress pedicle screw fixation assisted in the reduction of vertebrae fracture, which reduced the postoperative Cobb's angle loss. There was a significant difference in the change of Cobb's angle between the two groups one year after surgery (P<0.01). Conditional application of pedicle screws in a single thoracolumbar fracture enhances the stability of the internal fixation system and is conducive to the correction of kyphosis and maintenance of the corrective effects.
本研究旨在探讨通过骨折椎体垂直应力椎弓根螺钉固定加强胸腰椎骨折后路内固定的方法及效果。对单节段胸腰椎骨折患者进行回顾性研究。14例患者（A组）采用骨折椎体垂直应力椎弓根螺钉固定治疗，16例患者（B组）接受传统双钢板固定作为对照。所有患者均诊断为新鲜骨折，单侧或双侧椎弓根完整，椎体下半部及终板无爆裂。A组患者接受传统后路撑开及腰椎前凸恢复，并在骨折椎体垂直方向置入椎弓根螺钉以缓解应力，实现局部应力平衡。所有患者术后随访4 - 18个月（平均12.6个月）。垂直应力椎弓根螺钉固定有助于椎体骨折复位，减少术后Cobb角丢失。术后1年两组Cobb角变化差异有统计学意义（P<0.01）。单节段胸腰椎骨折有条件地应用椎弓根螺钉可增强内固定系统稳定性，有利于后凸畸形的矫正及矫正效果的维持。
