【摘要】 目的 应用AF内固定系统加人工骨填塞椎体成形术治疗创伤后胸腰椎压缩骨折，探讨胸腰椎压缩骨折有效的治疗方法。方法 采用AF脊柱内固定系统将56例胸腰椎骨折复位，并在骨折椎体中填塞人工骨。X线片、CT检查评价临床效果。结果 56例患者X线片、CT示椎弓根钉位置满意，骨折复位良好，术后无神经根损伤及脊髓损伤加重情况。随访患者20～26个月，平均24个月，临床症状明显好转，X线及CT片提示人工骨填塞胸腰椎矫正度的丢失明显减少，术后24个月遗留腰背痛减少。脊柱骨折复位效果：患者手术前、后Cobb’s角分别是22.8°(14°～43°)和4°(0°～8°)，24个月后4.5°(0°～9°)；术前椎体前缘平均高度为42%(24%～70%)，术后平均高度为96.4%(78%～100%)；术后24个月平均高度为96.2%(78%～98%)；术后24个月无疼痛者51例，轻度疼痛(偶尔在劳累后有轻微疼痛)4例，中度疼痛(经常有轻微的疼痛劳累后加重)1例。结论 采用AF内固定系统加人工骨填塞治疗创伤后胸腰椎压缩骨折能有效维持椎体的刚度、强度、高度，更好地防止后期脊柱后凸畸形的复发，减少腰背痛及其他并发症。

    【关键词】 胸腰椎骨折；AF内固定；椎体成形；ACPC；疗效分析

    The clinical analysis in treatment of thoracolumbar vertebral compression fractures with AF internal fixation systerm plus vertebroplasty by filling the injured vertebrae with artificial bones(autosetting calcium phosphate cement,ACPC)

    LIU Zhi-an,DENG Bin,LIU Sheng-cai,et al.

    Department of Orthopedics,Zhoushan GuangAn Hospital of Orthopdics and Traumatology,Zhoushan,316000,China

    【Abstract】 Objective To study the clinical effect of AF internal fixation plus vertebroplasty by filling the injured vertebrae with artificial bones(ACPC) in the treatment of thoracolumbar vertebral compression fractures.Methods 56 cases of thoracolumbar vertebral compression fracture were treated with AF device fixation and vertebroplasty by filling the injured vertebrae with ACPC.The clinical results were analyzed with X-ray and CT etc.The loss of Cobb's angle and the front and back height of the fractured vertebral body were followed-up for 20～26 months(average 24 months).Results All patients,who were checked with X-ray and CT scanning before and after operation,were perfectly recovered without notable correction loss or implant failure during the folow-up.And there was little loss of the normal spine curce and the spinal height of the injured vertebrae after 24 months.Cobb's angle was preoperatively 22.8°(14°～43°),postoperatively 4.0°(0°～8°),after 24 months 4.5°(0°～9°).The anterior height of the fractured vertebral body was preoperatively 42%(24%～70%),postoperatively 96.4%(78%～100%),after 24 months 96.2%(78%～98%);back pain relief was occurrence in 91.1% patients(51/56),light relief 7.1%(4/56),no relief was 1.8%(1/56).Conclusion The AF internal fixation plus vertebroplasty is an effective,convenient and valuable method in the treatment of thoraclumbar vertebral compression fracture.Through ACPC-grafting,the stiffness and the strength of the fractured vertebral body were significantly increased, the front height could be supported and kyphosis or back pain could be prevented or decreased,no severe complication occurred. ......