同种异体骨结合自体骨经伤椎椎弓根椎体内植骨治疗胸腰椎骨折的临床研究  

Clinical study of allogeneic bone combined with autologous bone by vertebral pedicle bone graft in the treatment of thoracolumbar fractures

作　　者：韩坤 

机构地区：[1]山东省胶州市人民医院骨科,266300

出　　处：《中国临床实用医学》2015年第2期7-9,共3页China Clinical Practical Medicine

基　　金：山东省科技发展计划项目（2011GNC11206）

摘　　要：目的评价同种异体骨结合自体骨经伤椎椎弓根椎体内植骨联合伤椎置钉短节段固定治疗胸腰椎骨折的临床疗效。方法选取2010年4月至2014年1月胶州市人民医院收治的胸腰椎骨折患者65例，行同种异体骨结合自体骨经伤椎椎弓根椎体内植骨联合伤椎置钉短节段固定术，对比分析患者手术前后VAS 疼痛评分、脊髓神经功能分级及影像学检查结果（包括伤椎前、后缘高度及Cobb 角）。结果所有患者手术均成功完成，平均随访17.4个月，除2例患者出现断钉现象，其余均无内固定物松动、断钉断棒、形成假关节等情况；VAS 评分显示，术后1、6、12个月患者的疼痛评分较术前显著降低（均P〈0.05），且随康复时间的延长，疼痛程度逐渐减轻（P〈0.05）；术后脊髓神经功能显著改善（P〈0.01）；影像学分析发现患者伤椎前、后缘高度及外形基本恢复，骨愈合良好。结论同种异体骨结合自体骨经伤椎椎弓根椎体内植骨联合伤椎置钉短节段固定治疗胸腰椎骨折疗效显著，有利于椎体复位和椎骨愈合，有效减少脊柱畸形的发生。Objective To evaluate the clinical curative effect of allogeneic bone combined with autologous bone transpedical interbody bone grafting combined with pedicle screw short-segment fixation in the treatment of thoracolumbar fractures. Methods 65 patients with thoracolumbar fractures admitted into the hospital from April 2010 to January 2014 were selected as the research object. All the patients were treated with autologous bone transpedical interbody bone grafting combined with pedicle screw short-segment fixation.The VAS pain scores,classification of spinal nerve function and the inspection results of imaging （including the height of the leading and trailing edge of injured vertebra and Cobb angle） were comparatively analyzed before and after surgery. Results 65 cases of operation were successfully completed,with a mean 17.4 months of follow-up in all patients.Except for 2 patients with broken screws,there was no loosening of internal fixation,screw breakage, formilation of pseudarthrosis and so on;the VAS score revealed that 1month,6 months and 12 months after the surgery,the pain scores of patients significantly reduce compared with that before the surgery（P〈0.05）,and with the prolonged recovery time, the degree of pain gradually reduced （P〈0.05） operation;the spinal cord nerve function improved markedly after the treatment （P〈0.01）;imaging analysis showed that the height of the leading and trailing edge of injured vertebra in patients and shape basically recovered with good bone healing. Conclusion The curative effect of allogeneic bone combined with autologous bone transpedical interbody bone grafting combined with pedicle screw short-segment fixation in the treatment of thoracolumbar fractures is obvious.The treatment is good for vertebrae reduction and vertebrae healing and effectively reduce the occurrence of spinal deformity.

关 键 词：胸腰椎骨折 同种异体骨 经伤椎椎弓根植骨 伤椎置钉短节段固定 

分 类 号：R683.205[医药卫生—骨科学]