Objective To investigate the application of posterolateral intervertebral foramen intervertebral bone graft fusion in overhaul of thoracolumbar burst fracture after internal fixation failure.Methods Twelve patients with thoracolumbar burst fracture underwent posterior internal fixation combined with posterolateral intervertebral foramen intervertebral bone graft fusion after internal fixation failure.The vertebral Cobb's angle and bone graft fusion were observed after operation.Results Patients were followed up for 20 ～ 36 months with a median of 24.6 months.The recovery of vertebral body height was satisfactory and angulation deformity disappeared after surgery.The Cobb's angle before surgery,after surgery and at the last follow-up was (20.14 ± 2.42) °,(3.21 ± 2.01) ° and (3.34 ± 2.18) °,respectively.There were significant differences between that before and after surgery,and between that before surgery and that at last follow-up (P＜0.01),while no significant difference between that after surgery and that at last follow-up (P ＞0.05).Postoperative X ray and three-dimensional CT showed that all bone grafts were I period fusion and the fusion time was 4 ～ 6 months with a median of 4.6 months.Conclusion The application of posterior internal fixation combined with posterolateral intervertebral foramen intervertebral bone graft fusion can effectively prevent internal fixation failure and reset after the loss and convex deformities in patients with thoracolumbar burst fracture internal fixation failure.%目的 探讨经后外侧椎间孔椎间植骨融合技术在胸腰椎爆裂骨折手术后内固定失败翻修中的应用.方法 对12例胸腰椎爆裂骨折手术后内固定失败患者采用后路内固定结合经后外侧椎间孔椎间植骨融合术进行翻修,观察后椎体Cobb's角变化和植骨融合情况.结果 12例患者均获随访,随访时间20～36个月,中位数24.6个月.术后椎体高度恢复满意,成角畸形消失.手术前Cobb's角为(20.14±2.42)°,手术后Cobb's角为(3.21±2.01)°,末次随访时Cobb's角为(3.34±2.18)°,手术前后Cobb's角比较,差异有统计学意义(P＜0.01);末次随访与手术后Cobb's角比较,差异无统计学意义(P＞0.05).术后根据X线片及三维CT复查,所有植骨均一期融合,融合时间4～6个月,中位数4.6个月.结论 采用后路内固定结合经后外侧椎间孔椎间植骨融合术对胸腰椎爆裂骨折手术后内固定失败进行翻修,能有效防止内固定再次失败、复位丢失和后凸畸形.
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