后路椎弓根螺钉联合经椎弓根羟基磷灰石人工骨植骨治疗胸腰段爆散骨折的效果观察  

Effect observation of posterior pedicle screw fixation combined with transpedicular hydroxyapatite bone grafting treatment in thoracolumbar burst fracture

作　　者：南军[1] 元虎[1] 李康杰[1] 

机构地区：[1]延边大学附属医院骨科,吉林延吉133000

出　　处：《中国医药导报》2013年第15期54-57,共4页China Medical Herald

摘　　要：目的评价联合应用后路椎弓根螺钉固定联合及经伤椎椎弓根羟基磷灰石植骨治疗胸腰段爆散骨折的临床及影像学疗效。方法选择2008年3月～2010年3月在延边大学附属医院骨科因胸腰段爆散骨折接受手术治疗患者36例,根据手术方式分为A、B两组,A组20例采用单纯内固定,B组16例在单纯内固定基础上联用经椎弓根羟基磷灰石人工骨椎体内植骨。术后12个月取出内固定。比较两组术前、术后3、12、24个月的伤椎楔变角、局部后凸角、椎体前缘压缩比、Denis疼痛与功能状态评分。结果未发生手术相关并发症及内固定断裂。术前、术后3个月两组伤椎楔变角、后凸角、椎体前缘压缩比等指标比较差异无统计学意义(P>0.05)。术后12个月取内固定前A组伤椎楔变角[(11.2±1.7)°]、后凸角[(11.2±2.0)°]、椎体前缘压缩比[(0.79±0.15)]与B组[(9.5±2.2)°、(9.7±2.1)°、(0.87±0.16)]比较,差异均有统计学意义(均P<0.05);术后24个月A组伤椎楔变角[(12.2±2.6)°]、后凸角[(12.3±2.6)°]、椎体前缘压缩比[(0.78±0.13)]与B组[(10.1±2.7)°、(10.3±2.7)°、(0.85±0.18)]比较,差异均有统计学意义(均P<0.05)。两组在Danis疼痛评分和功能状态差异均无统计学意义(P>0.05)。结论经椎弓根羟基磷灰石人工骨植骨可以有效的协助术后矫形度数的维持,维持脊柱的矢状序列,防止内固定失效,但是其对患者术后疼痛及功能状态的影像有待长期随访研究。Objective To evaluate the clinical and imaging efficacy of posterior pedicle screw fixation and transpedicular hydroxyapatite bone graft in the treatment of thoracolumbar burst fracture.Methods 36 patients of thoracolumbar burst fractures in Affiliated Hospital of Yanbian University from March 2008 to March 2010 were selected and divided into group A and group B according to the operation methods,20 cases in group A were treated with posterior pedicle screw reduction and fixation,16 cases in group B were treated with transpedicular hydroxyapatite bone graft combined with posterior pedicle screw reduction and fixation.Internal fixation was taken out 12 months after the operation.Fractured vertebral wedged angle,local kyphosis angle,anterior vertebral compression ratio,Denis pain and functional status score were compared between the two groups.Results No surgery related complications and the fracture internal fixation was found.The differences of fractured vertebral wedged angle,local kyphosis angle,anterior vertebral compression ratio in the two groups before and 3 months after the operation were not statistically significant（P 0.05）.The differences of fractured vertebral wedged angle,local kyphosis angle,anterior vertebral compression ratio in group A [（11.2 ±1.7）°,（11.2 ±2.0）°,（0.79 ±0.15）] and group B [（9.5 ±2.2）°,（9.7 ±2.1）°,（0.87±0.16）] were statistically significant（P 0.05）;the differences of fractured vertebral wedged angle,local kyphosis angle,anterior vertebral compression ratio in group A [（12.2 ±2.6）°,（12.3±2.6）°,（0.78±0.13）] and group B [（10.1±2.7）°,（10.3±2.7）°,（0.85±0.18）] were statistically significant（P 0.05）.The differences of Denis pain and functional status scores in the two groups were not statistically significant（P 0.05）.Conclusion Transpedicular hydroxyapatite bone grafting can effectively assist the maintenance of postoperative correction and spinal sagittal alignment to prevent fixation failure.The long-term

关 键 词：胸腰段骨折 爆散骨折 羟基磷灰石 经椎弓根植骨 

分 类 号：R684.705[医药卫生—骨科学]