伤椎椎弓根钉交叉内固定联合椎弓根植骨治疗腰椎双椎体爆裂性骨折疗效研究  

Curative injured vertebral pedicle screw cross internal fixation combined with pedicle bone grafting for lumbar double vertebral burst fractures

作　　者：张亮[1] 朱锋 金根洋 ZHANG Liang;ZHU Feng;JIN Gen-yang(Department of Orthopedics,904 Hospital of The Joint Logistics Support Force of The Chinese People'sLiberationArmy,Wuxi 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院骨科,江苏无锡214000

出　　处：《哈尔滨医科大学学报》2022年第4期383-386,共4页Journal of Harbin Medical University

基　　金：江苏省自然科学基金面上项目(BK20201139)。

摘　　要：目的探讨伤椎椎弓根钉交叉内固定联合椎弓根植骨治疗腰椎双椎体爆裂性骨折的效果。方法选择2016年4月~2020年1月本院收治的52例腰椎双椎体爆裂性骨折患者为研究对象,以随机数字表法分为观察组(26例)与对照组(26例)。其中对照组采用伤椎椎弓根钉交叉内固定治疗,观察组采用伤椎椎弓根钉交叉内固定联合椎弓根植骨治疗,比较两组相关康复指标(术中出血量、术后引流量、手术时间),比较两组术前、术后1年矢状位椎体Cobb角、椎体前缘高度、日本骨科协会(Japanese Orthopaedic Association,JOA)评分,对比两组术后3个月内并发症发生情况。结果观察组的手术时间长于对照组(P<0.05),观察组的术后引流量以及术中出血量高于对照组(P<0.05);两组术前的JOA评分、矢状位椎体Cobb角以及椎体前缘高度比较,差异无统计学意义(P>0.05);两组术后1年的矢状位椎体Cobb角低于术前(P<0.05),且观察组更低(P<0.05);两组术后1年的JOA评分、椎体前缘高度比术前高(P<0.05),且观察组更高(P<0.05)。术后3个月内,两组总并发症发生率比较,差异无统计学意义(P>0.05)。结论伤椎椎弓根钉交叉内固定联合椎弓根植骨可改善腰椎双椎体爆裂性骨折患者的腰椎曲度与伤椎高度,可减轻腰痛,且安全可靠。Objective To investigate the effect of injured vertebral pedicle screw cross internal fixation combined with pedicle bone grafting in the treatment of lumbar double vertebral burst fractures.Methods A total of 52 patients with lumbar double vertebral burst fractures admitted to the hospital from April 2016 to January 2020 were selected.They were divided into control group(26 cases)and observation group(26 cases)by random number table method.The control group was treated with injured vertebral pedicle screw cross internal fixation,and the observation group was treated with injured pedicle screw cross internal fixation combined with pedicle bone grafting.The two groups of related rehabilitation indicators(intraoperative blood loss,postoperative drainage,operation time)were compared.The Cobb angle of the sagittal vertebral body,the height of the anterior edge of the vertebral body,and the scores of the Japanese Orthopaedic Association(JOA)were compared between the two groups before and 1 year after the operation.The occurrence of complications within 3 months after the operation was compared between the two groups.Results The operation time of the observation group was longer than control group(P<0.05),and the postoperative drainage and intraoperative blood loss of the observation group were higher than control group(P<0.05).The preoperative JOA score,the Cobb angle of the sagittal vertebral body and the height of the anterior edge of the vertebral body were not statistically different between the two groups(P>0.05).The Cobb angle of the sagittal vertebral body of the two groups was lower than that of the preoperation 1 year later(P<0.05),and it was lower in the observation group(P<0.05).The JOA score and the height of the anterior edge of the vertebral body at 1 year after surgery were higher in the two groups than before the operation(P<0.05),and higher in the observation group(P<0.05).There were no significant differences in the total complication rate between the two groups within 3 months after operation(P>0.05

关 键 词：伤椎椎弓根钉交叉内固定 椎弓根植骨 腰椎双椎体爆裂性骨折 安全性 

分 类 号：R683.2[医药卫生—骨科学]