计算骨丧失量经椎弓根打压植骨治疗胸腰椎压缩性骨折的生物力学研究与临床应用  

Biomechanical Study and Clinical Application of Thoracolumbar Compression Fracture Treated with Transpedcular Impacted Grafting Using Account Osteal Loss Quantity

作　　者：叶春万 朱敏[1] 甘业春 樊道斌 王欣[1] 

机构地区：[1]安徽省巢湖市骨科医院创伤病区,238000

出　　处：《中国骨与关节损伤杂志》2011年第5期394-397,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨用自行设计的计算骨丧失量的方法经椎弓根伤椎内打压植骨（TPIG）结合钉棒系统复位内固定治疗胸腰椎压缩性骨折的生物力学性能及临床疗效。方法对计算骨丧失量TPIG结合钉棒内固定治疗胸腰椎压缩性骨折的方法进行生物力学实验与临床应用。结果计算骨丧失量TPIG结合椎弓根固定的椎体和椎间盘的强度、刚度以及抗扭转的生物力学性能良好。应用计算骨丧失量TPIG治疗胸腰椎压缩性骨折46例，患者的伤椎在术后达到或基本达到解剖复位。44例获得随访，时间13～22个月（平均17个月）。末次随访椎体前缘高度和术后一致，Cobb角亦和术后相同，无明显的矫正度丢失及内固定并发症。术后末次随访的VSA评分：0分36例，1．3分8例。结论计算骨丧失量TPIG结合椎弓根固定治疗胸腰椎压缩性骨折消除了压缩椎体的蛋壳现象，给伤椎体提供了即刻稳定性，达到了与内固定物共同承载负荷的目的，减少了内固定的并发症。Objective To explore biomechanical characteristic and clinical results of thoracolumbar compression fracture treated with transpedicular impacted grafting （TPIG） using account osteal loss quantity. Methods The transpedecular bone grafting account osteal loss quantity underwent a biomechanical test and a comparative analysis of clinical application was performed. Results It was by far better than transpedicular grafting in tension,stiffiness,and stability of vertebral body and intervertertebral disc of （P 〈0.05 ）. Forty-six cases of thoracolumbar spine fracture were treated with TPIG osteal loss quantity, and 46 of them were followed-up for 13 to 22 months（average,17 months）. The anterior body height was satisfying at last follow-up. The Cobb angle loss was not significant at last follow-up. No loss of correction and complications of internal fixation were found. Conclusion Transpedicular bone grafting for thoraeolumbar fracture using account osteal loss quantity can eliminate egg shell and recovery height of vertebral body, at one time provide the spinal stability immediately and can decrease fixation complication.

关 键 词：胸腰椎骨折 计算骨丧失量 经椎弓根打压植骨 生物力学 内固定 

分 类 号：R683.2[医药卫生—骨科学]