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[目的]探讨膨胀式椎弓根螺钉固定联合椎体成形治疗严重骨质疏松椎体爆裂骨折治疗效果。[方法]回顾分析2006年10月-2009年3月,应用膨胀式椎弓根螺钉固定联合椎体成形治疗严重骨质疏松椎体爆裂骨折14例,年龄61~77岁,平均65岁,椎体压缩高度:30%~75%,平均60%。椎管占位情况:25%~50%11例,50%~75%3例。骨质疏松按Jike i分级Ⅱ级8例,Ⅲ级6例。[结果]经过6~27个月,平均16个月的随访。椎体高度恢复92%~100%,平均96.8%。椎管直径恢复80%~96%,平均88%。神经恢复情况:所有Ⅲ~Ⅳ级病例全部恢复功能。内置物无1例出现折断、弯曲、松动现象。无1例出现伤口感染。[结论]膨胀式椎弓根螺钉系统固定联合椎体成形治疗严重骨质疏松椎体爆裂骨折,最大限度的恢复了椎体的高度和强度,减少了内置物松动,避免了椎体高度的再丢失,为早期活动,减少并发症提供了基础,是治疗该类型骨折的有效方法。
[Objective] To investigate the therapeutic effect of expanding pedicle screw fixation combined with vertebroplasty in the treatment of severe osteoporotic vertebral burst fracture. [Methods] From October 2006 to March 2009, 14 cases of severe osteoporotic vertebral body burst fractures were treated with expansion pedicle screw fixation and vertebroplasty. The patients were 61 to 77 years old with an average of 65 years. Body compression height: 30% ~ 75%, an average of 60%. Spinal canal occupancy: 25% to 50% in 11 cases, 50% to 75% in 3 cases. According to Jike i osteoporosis grade Ⅱ 8 cases, Ⅲ grade 6 cases. [Results] After 6 to 27 months, an average of 16 months follow-up. Vertebral height recovery 92% to 100%, an average of 96.8%. Spinal canal diameter recovery of 80% to 96%, an average of 88%. Nerve recovery: all Ⅲ ~ Ⅳ grade cases fully restored function. No one built-in objects appear broken, bent, loose phenomenon. No case of wound infection. [Conclusion] Expansion of pedicle screw system combined with vertebroplasty in the treatment of severe osteoporotic vertebral burst fractures, to maximize the restoration of the vertebral height and strength, reduce the loosening of the contents, to avoid the vertebral body height and then Lost, for the early activities, to reduce complications provide the basis for the treatment of this type of fracture is an effective method.