椎弓根钉联合伤椎自体骨移植与联合注射性硫酸钙治疗胸腰椎骨折的对比研究  

A Comparative Study on Pedicle Screw Combined with Autologous Bone Graft and Combined with Injectable Calcium Sulfate in Treatment of Thoracolumbar Fracture

作　　者：宋留红 刘彬[1] 史艳光 刘谋均 刘德祥[1] 陈涛[1] 吴飞雁[1] SONG Liu-hong LIU Bin SHI Yan-guang LIU Mou-jun LIU De-xiang CHEN Tao WU Fei-yan(Department of Or- thopedics, People＇s Hospital of Pengzhou City, Pengzhou, Sichuan 611930, China)

机构地区：[1]彭州市人民医院骨科,四川彭州611930

出　　处：《解放军医药杂志》2017年第1期71-75,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：彭州市科技计划项目(2014-107-18)

摘　　要：目的比较椎弓根钉联合伤椎自体骨移植与椎弓根钉联合注射性硫酸钙治疗胸腰椎骨折的效果及预后。方法选择四川省彭州市人民医院骨科2013年8月—2015年9月收治的胸腰椎骨折60例,根据入院顺序分为A、B组,每组30例。2组均给予脊柱后路椎弓根钉系统复位内固定+脊柱融合术,A组在此基础上给予自体骨移植,B组给予注射性硫酸钙,观察2组手术效果及预后情况。结果 2组手术成功率均为100.00%。2组手术时间、术中出血量、住院时间比较差异无统计学意义(P>0.05),但B组住院费用高于A组(P<0.05)。B组术后骨缺损发生率低于A组,骨缺损程度较A组轻(P<0.05)。2组术后即刻、出院时、术后各时段Cobb角、椎体前缘高度压缩率、视觉模拟量表(VAS)评分均较术前降低,出院时和术后各时段Cobb角和椎体前缘高度压缩率较术后即刻增高,VAS评分低于术后即刻(P<0.05);B组术后即刻、出院时、术后3个月VAS评分高于A组,术后即刻和出院时Cobb角小于A组,推体前缘高度压缩率高于A组(P<0.05)。2组出院时、术后各时段ODI评分较术前明显降低,且术后各时段低于出院时(P<0.05)。结论椎弓根钉联合自体骨移植和椎弓根钉联合注射性硫酸钙治疗胸腰椎骨折手术效果相当,虽然注射性硫酸钙术后骨缺损发生率低且程度轻微,但其费用高昂,临床应合理选择手术方案。Objective To compare effect and prognosis of pedicle screw combined with autologous bone graft and combined with injectable Calcium Sulfate in treatment of thoracolumbar fracture. Methods A total of 60 patients with thoracolumbar fracture during August 2013 and September 2015 were divided into group A and B （n = 30 for each group） according to the admission time. All patients underwent posterior spinal pedicle screw system internal fixation reduction and spinal fusion, while group A was added with autologous bone graft, and group B was injected with Calcium Sulfate, and then operative effect and prognosis were observed in two groups. Results The success rates of the two groups were 100% , and there were no significant differences in operative time, intraoperative volume of blood loss and hospitalization time between two groups （P 〉 0. 05）. The hospitalization cost in group B was significantly more than that in group A （P 〈 0. 05 ）. The incidence rate of postoperative bone defect in group B was lower than that in group A, and degree of bone defect in group B was better than that in group A （P 〈 0.05）. After operation in two groups, values of Cobb angle, compression rate of anterior height of vertebral body, VAS score at postoperative immediately, at discharge and postoperative different times were significantly lower compared with those preoperative, and the values of Cobb angle and compression rate of anterior height at discharge and postoperative different times were significantly increased, while VAS scores were lower compared with those at postoperative immediately （P 〈 0. 05）. VAS scores at postoperative immediately, at discharge and in postoperative 3 months were significantly higher, while values of Cobb angle were lower, and compression rates of anterior height were higher at postoperative immediately and at discharge in group B than those in group A （P 〈 0.05）. In two groups, ODI scores at postoperative immediately and postoperative different times were significantly decr

关 键 词：胸腰椎 骨折 椎弓根钉 骨移植 移植 自体 硫酸钙 

分 类 号：R683.2[医药卫生—骨科学]