前路减压纳米羟基磷灰石-酰胺66人工椎间支撑体治疗爆裂性胸腰椎骨折的中期疗效观察  

Mid-term clinical effect of anterior decompression plus intervertebral fusion cage with nano- hydroxyapatite and polyamide 66 composite for thoracolumbar burst fractures

作　　者：陈日高[2] 宋跃明[1] 刘立岷[1] 李涛[1] 龚全[1] 曾建成[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]四川省中医院

出　　处：《中华创伤杂志》2011年第9期774-778,共5页Chinese Journal of Trauma

基　　金：国家“十一五”科技支撑计划资助项目（2007BAE131304）

摘　　要：目的评价纳米羟基磷灰石／聚酰胺66（ nano - hydrxyapatite crystal, n - HA/polyamide 66, PA66）椎间支撑体治疗爆裂性胸腰椎骨折的中期临床效果。方法2007年12月-2008年12月，对87例爆裂性胸腰椎骨折患者采用前路减压n—HA／PA66椎间支撑体植骨融合内固定治疗，对临床效果、安全性及影像学结果进行评估。结果平均随访21．3个月（17—24个月）。术后无神经损害加重患者。除4例FrankelA级患者，所有患者神经功能均有1—2级恢复。矢状位后凸角术前为（14．4±12．6）°，术后为（3．7±8．7）°，末次随访时为（4．0±8．3）°。伤椎邻近上下椎体间高度术前为（96．9±17．2）mm，术后为（109．5±17．1）mm，末次随访时为（108．3±16．4）mm。随访期间未见椎间支撑体移位、内固定断裂或神经功能损害加重。58例达到E级融合，22例D级融合，7例C级融合。结论前路减压n—HA／PA66椎间支撑体植骨融合内固定治疗爆裂性胸腰椎骨折安全可行。术后椎间高度恢复满意，后凸畸形纠正明显，中期随访椎体间高度无丢失，融合满意。Objective To evaluate the mid-term clinical effect of nano-hydroxyapatite and poly-amide 56 （ n-HA/PA66 ） intervertebral fusion cage in treatment of thoracolumbar burst fractures. Methods A total of 87 patients with thoracolumbar burst fractures were managed by thoracolumbar body resection combined with n-HA/PA66 intervertebral fusion cage from December 2007 to September 2008. The clinical effect, safety and radiographic outcomes were evaluated. Results No nerve damage was deteriorated in all the patients. The neural function was improved for 1-2 grade except for four patients at Frankel grade A. The patients were followed up for mean 21.3 months （ 17-24 months）. The kyphosis was （ 14.4±12.6） ° preoperatively, （3.7±8.7） ° immediately after surgery and （4.0±8.3 ） ° at final follow-up. The distance between the upper and lower vertebral bodies was （96.9± 17.2） mm preoperatively, （109.5 ± 17.1 ） mm immediately after surgery and （108.3±16.5） mm at final follow-up. No cage replacement, internal fixation breakage or neurologic impairment were observed during follow-up period. There were 58 patients with grade E fusion, 22 with grade D fusion and 7 with grade C fusion. Conclusions Anterior decompression combined with n-HA/PA66 intervertebral fusion cage is an effective method for treatment of thoracolumbar burst fracture. The kyphosis is rectified and the intervertebral distance is corrected, with a high rate of fusion.

关 键 词：脊柱骨折 胸椎 腰椎 n—HA/PA66椎间支撑体 

分 类 号：R687.3[医药卫生—骨科学]