胸腰椎爆裂性骨折经椎管椎体内植骨空洞形成原因的初步探讨  

Preliminary Study of Thoracolumbar Burst Fractures through the Spinal Vertebral Bone Graft Absorption Void Formation

作　　者：覃建朴 王翀 曹广如 敖俊 TAN Jianpu , WANG Chong,CAO Guangru,AO Jun （Department of spine surgery, Affiliated Hospital of Zunyi Medical College , Zunyi Guizhou 563000）

机构地区：遵义医学院附属医院脊柱外科,贵州遵义563000

出　　处：《系统医学》2016年第1期41-46,共6页Systems Medicine

基　　金：贵州省科技厅科学技术基金课题（黔科合J字[2010]2179号）;遵义医学院博士启动基金课题（No：遵医院办发[2010]1）

摘　　要：目的观察胸腰椎爆裂性骨折经椎弓根钉棒系统固定并结合经椎管伤椎体内植骨成形术后伤椎体内空洞的发生率、位置、大小及其愈合情况,探讨植骨吸收空洞发生的形成原因。方法对2009年1月—2013年12月间61例胸腰椎爆裂性骨折经椎弓根钉棒系统固定结合经椎管椎体内植骨成形术后14-26个月返院取出内固定患者伤椎进行CT扫描＋三维重建,其中T11椎6例、T12椎21例、L1椎29例、L2椎5例。统计伤椎植骨空洞形成的发生率,观察空洞的位置、大小及其愈合情况。结果 61例植骨吸收空洞发生率93.44%,空洞主要位于伤椎椎体前上部。结论其形成可能与椎体伤后局部血运、损伤程度、植骨密度及植骨材料、自身松质骨特性、椎体区域性骨密度分布差异、椎体所受压应力分布差异等多方面因素有关。伤椎植骨空洞形成的发生率高,但近期对内固定和伤椎畸形矫正度无明显影响。Objective To observe the thoracolumbar burst fracture by pedicle screw fixation combined with the system via spinal vertebral bone forming voids within the vertebral body after injury incidence, location, size and healing, explore the cause of the bone absorption cavity formation. Methods January 2009- December 2013 among 61 cases of thoracolumbar burst fractures by pedicle screw fixation combined system via spinal vertebral bone forming within 14 to 26 months after return to hospital to remove the fixed CT scans of patients injured vertebrae + three-dimensional reconstruction, which T11 vertebral six cases, T12 vertebra 21 cases, L1 vertebra 29 cases, L2 vertebral five cases. Statistical incidence of voids observed empty location, size and healing. Results 61 cases of bone absorption rate of 93.44%, voids are mainly located in the upper front vertebral body. Conclusion It may be the local blood supply and vertebral injury, the extent of damage, bone mineral density and planting materials, their properties of cancellous bone, the vertebral bone mineral density distribution of regional differences in the distribution of vertebral compressive stress differences are more than its form factors related to the high incidence, but the recent correction of the internal fixation and had no significant effect.

关 键 词：胸腰椎爆裂性骨折 经椎管椎体内植骨 植骨吸收空洞 

分 类 号：R683.2[医药卫生—骨科学;医药卫生—临床医学;医药卫生—外科学]