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目的探讨经伤椎椎弓根螺钉内固定治疗胸腰椎骨折的可行性、适应症及临床疗效。方法自2012年3月~2014年3月采用后路经伤椎植骨内固定治疗胸腰椎骨折30例，分别于术后3~5d、12个月、末次随访时复查X线片及CT，对伤椎Cobb角、椎体压缩百分比、椎管占位、内固定物状况进行随访；通过Frankel标准对脊髓神经功能进行评定。结果所有病例均获得l2~36个月随访，所有病例均获得骨性融合，无假关节形成。伤椎Cobb角由术前的(25.6±9.7)o矫正至术后(9.1±4.1)o，末次随访时(10.2±4.7)o；椎体压缩百分比由术前(48.3±10.1)豫恢复至术后(6.5±3.2)豫,末次随访时(7.5±3.7)豫；术后与术前比较差异有统计学意义(0.05)。椎管矢状径占位率由术前的(36.9±11.2)豫恢复至术后(6.3±4.7)豫、术后l2个月时(6.4±4.5)豫，术后与术前比较差异有统计学意义(0.05)。脊髓神经功能除1例A级无变化外，其余均有1~2级的恢复。结论经伤椎椎弓根钉复位、内固定治疗胸腰椎骨折具有创伤小、固定节段少、脊柱稳定性好、能有效矫正及预防脊柱后凸畸形等优点。“,”Objective To observe the ef icacy,indication and clinical outcome of fixation via injured vertebra for the treatment of thoracolumbar fracture.Methods From March 2012 to March 2014,30 patients with thinacolumbar fracture underwent surgical procedure of reduction and pediele screw at the fracture level,X-rays and CT scans were performed after operation,Cobb angle of the injured vertebral segment,the percentage of vertebral compression,and sagit al diameter stenosis rate of the injured spinal canal were observed for radiographic evaluation.Neurological function was evaluated by the Frankel scale.Results Al patients were fol1owed-up from 12 to 36 months.There was no pseudoarticulation,solid bone fusion was achieved in al cases.Cobb angle of the injured vertebral segment was cor ected from preoperative (25.6±9.7)degree to postoperative (9.1±4.1)degree and (10.2±4.7)degree at last fol ow-up.The percentage of vertebral compression was cor ected from preoperative (48.3±10.1)%to postoperative(6.5±3.2)%and(7.5±3.7)%at last fol ow-up.Spinal canal sagit al diameter stenosis rate was cor ected from preoperative(36.9±11.2)%to postoperative(6.3±4.7)%and(6.4±4.5)%one year after operation.The spinal cord function was improved 1 to 2 degree in al patients except 1 patients of grade A.Conclusion Indirect reduction and fixation with pedicle screw to treat thoracolumbar vertebral fracture have several advantages:less trauma,less stif ness,less complications with more stable vertebral column,which can rectify or prevent kyphosis ef ectively.