自体骨联合同种异体骨与同种异体骨在治疗胸腰椎爆裂骨折中的疗效差异  

Allogeneic combined with or without autogenous bone implantation in treatment of thoracolumbar burst fracture

作　　者：王振昊[1] 彭磊[1] 刘建莉[1] 程少文[1] 袁伟[1] 朱恒杰[1] 郭远学 

机构地区：[1]海南医学院附属医院,海口570102

出　　处：《中国矫形外科杂志》2016年第14期1278-1282,共5页Orthopedic Journal of China

基　　金：2015年度海南省自然科学基金项目(编号:20158346)

摘　　要：[目的]探讨自体骨联合同种异体骨与同种异体骨植入治疗胸腰段椎体爆裂性骨折的临床疗效。[方法]本院骨科2011年1月~2014年1月共收治60例胸腰段椎体爆裂性骨折患者,采用随机数字表法分为联合组与对照组各30例,联合组采用后路经单侧椎弓根植入自体骨联合同种异体骨治疗,对照组采用后路经单侧椎弓根植入同种异体骨治疗,对比两组临床治疗效果的差异。[结果]术后末次随访联合组的椎体前缘高度大于对照组,Cobb角小于对照组,且差异均具有统计学意义（P〈0.05）。联合组术后3、6个月、末次随访的植骨融合率分别为40%、60%、86.67%,均显著高于对照组的13.33%、26.67%、63.33%（P〈0.05）。联合组和对照组的脊髓神经损伤功能分级在术前、术后组间比较差异无统计学意义（P〉0.05）,术后两组患者的脊髓神经损伤功能均较术前显著好转（P〈0.05）。[结论]自体骨联合同种异体骨较同种异体骨植入治疗胸腰段椎体爆裂性骨折,能够更显著的促进植骨融合,减少骨缺损,对减少术后Cobb角、椎体前缘高度丢失具有更显著的作用。[ Objective ] To compare the therapeutic effects of autogenous combined with allogeneic implantation versus merely allogeneic implantation bone grafting in the treatment of thoracolumbar vertebral burst fracture, so as to find out which one is better. [ Method] Sixty thoracolumbar vertebral burst fracture patients, who were admitted into our hospital from January 2011 to January 2014, were randomly divided into combined treatment（ autogenous combined with allogeneic） group and control （allogeneic alone） group,with 30 cases in each group. Patients in combined group received posterior unilateral transpedicular autogenous combined with allogenous bone grafting, while those in the control group were given unilateral transpedicular implantation of allogeneic bone alone. The therapeutic effects between two groups were compared at 3 month ,6 month post - operatively and at the last follow - up. [ Result] At the last follow - up,the height of anterior vertebraeedge in the combined group was high- er than that in the control group, and the Cobb angle was smaller than that of the control group, showing statistically significant differences（P 〈 0.05 ）. The fusion rate of bone graft in the combined group were 40% ,60% and 86.67% at 3 month,6 month and the last follow - up ,significantly higher than those in the control group（ 13.33% ,26.67% ,and 63.33% ,respectively,P 〈 0.05 ）. The spinal nerve function injury grading（ASIA） scores was not found significant difference between two groups no matter before - and after surgery （ P 〉 0.05 ）, but in both two groups, the postoperative scores increased obviously than preoperative ones, with significant difference（ P 〈 0.05 ）. [Conclusion] Compared with allogeneic bone grafting alone, autogenous combined with allogeneic bone grafting can promote bone graft fusion, reduce bone defect, maintain the postoperative Cobb angle and vertebral height. Therefore,it is a better choice for thoracolumbar burst fracture.

关 键 词：自体骨 同种异体骨 胸腰段椎体爆裂性骨折 

分 类 号：R687.3[医药卫生—骨科学]