尚平福++++++徐钦华++++++王贵方++++++李东风

    [摘要] 目的 探讨椎板开窗减压联合经伤椎椎弓根撬拨复位椎体内植骨治疗胸腰椎骨折的临床效果。 方法 回顾性分析2010年8月～2013年5月在邯郸钢铁集团有限责任公司职工医院收治的63例损伤类型为AO-A型且伴有椎管侵占的胸腰椎骨折患者资料，根据手术方式将其分为两组，A组：30例，采用椎板开窗脊髓减压撬拨复位椎体内植骨术；B组：33例，采用开窗减压短节段椎弓根钉撑开固定术。分别记录两组患者手术时间、术中出血量和术前、术后及末次随访时的椎体相对高度、局部后凸角(Cobb角)及Oswestry功能障碍指数(ODI)。 结果 所有手术均顺利完成，切口均Ⅰ期愈合。B组手术时间及术中出血量上明显少于A组，差异有统计学意义(P 0.05)。两组患者术后ODI评分均显著降低(P 0.05)。 结论 开窗减压撬拨复位联合椎体内植骨术虽然会增加手术时间，但可更好地维持伤椎高度及脊柱序列，同时减少空壳样椎体的发生。

    [关键词] 胸腰椎骨折；撬拨复位；椎体内植骨；椎板减压

    [中图分类号] R683 [文献标识码] A [文章编号] 1673-7210(2017)07(c)-0109-05

    [Abstract] Objective To investigate the clinical effect of laminectomy decompression and poking reduction combined with vertebral bone graft for thoracolumbar fracture with spinal canal encroachment. Methods All of 63 patients who had thoracolumbar fracture in AO-A type accepted operation in the period of August 2010 to May 2013. They were divided into two groups based on the surgical procedure. The group A (30 cases) was accepted laminectomy decompression and poking reduction combined with vertebral bone graft. The group B (33 cases) was accepted short-segment fixation and laminectomy decompression. The operative time ......