不同植骨方式结合短节段椎弓根系统治疗胸腰椎爆裂骨折临床对比研究  

Effect of different grafting combined with short-segment pedicale instrumentation on thoracolumbar burst fractures

作　　者：蒋煜文[1] 刘海峰[1] 黄明光[1] 李飞[1] 赵洪斌[1] 陈伟[1] 杜庆钧[1] 

机构地区：[1]南方医科大学附属顺德第一人民医院骨科,广东佛山528300

出　　处：《海南医学》2013年第16期2368-2370,共3页Hainan Medical Journal

摘　　要：目的评价单纯后外侧植骨、经椎弓根椎体内植骨及联合植骨三种植骨方法治疗胸腰椎骨折的临床疗效。方法回顾性分析2004年11月至2011年11月我院三种植骨方式治疗的177例胸腰椎骨折患者的临床资料。其中单纯后外侧植骨(A组)72例,经伤椎椎弓根椎体内植骨(B组)63例,联合两种植骨方式植骨42例(C组)。观察伤椎Cobb角以及矫正度丢失、骨性融合率、内固定失效率、Oswestry功能障碍指数(ODI)情况变化。结果三组患者均获随访。末次随访时A组和B组Cobb角及矫正丢失度均大于C组,差异有统计学意义(P<0.05),但A组和B组间差异无统计学意义(P>0.05)。末次随访时,A组和B组骨性融合率与C组比较差异有统计学意义(P<0.05),但A组和B组间比较差异无统计学意义(P>0.05)。术后各组ODI均较术前有明显改善(P<0.05),末次随访时各组间比较差异无统计学意义(P>0.05)。结论胸腰椎骨折准确的评估非常重要,联合植骨融合可能较单纯后外侧或经椎弓根椎体内植骨融合获得更好的骨性融合。Objective To evaluate the effect of different grafting （posterolateral bone graft fusion;centrum bone graft fusion; centrum combined with posterolateral bone graft fusion） on thoracolumbar burst fractures.Methods A retrospective analysis was conducted in 177 cases of thoracolumbar burst fractures treated by posterolateral bone graft fusion （group A,n=72）,centrum bone graft fusion （group B,n=63）,and centrum combined with posterolateral bone graft fusion （group C,n=42）.The changes of the Cobb angle,correction loss of Cobb angle,bone fusion rate,internal fixation failure rate and Oswestry Disability Index （ODI） were observed.Results At the last follow-up,the Cobb angle and correction loss in group A and group B were significantly larger than those in groups C （P＜0.05）,with no statistically significant difference between group A and group B.The bone fusion rate and internal fixation failure rate in group A and group B were significantly different from those in group C （P＜0.05）,with no statistically significant difference between group A and group B.ODI were significantly improved after operation （P＜0.05）,with no significant difference between the three groups （P＞0.05）.Conclusion combine with posterolateral boned graft fusion may be better than single bone grafting.

关 键 词：胸腰椎爆裂性骨折 经椎弓根椎体植骨 后外侧植骨 联合植骨 

分 类 号：R683[医药卫生—骨科学]