CT三维重建辅助下精确定量法经椎弓根植骨联合伤椎置钉短节段固定治疗胸腰椎爆裂骨折的前瞻性对照研究  

A prospective controlled study on the treatment of thoracolumbar burst fractures using precise quantitative method of transpedicular bone grafting combined with short segment fixation of injured vertebrae with CT threedimensional reconstruction assistance

作　　者：杨勇 胡青青 蔡教斌 顾宏林[2] Yang Yong;Hu Qingqing;Cai Jiaobin;Gu Honglin(Department of Orthopedics,Shangyou County People′s Hospital,Ganzhou 341200,China;Department of Spinal Surgery,Guangdong Provincial People′s Hospital,Guangzhou 510080,China)

机构地区：[1]江西省上犹县人民医院骨科,赣州341200 [2]广东省人民医院脊柱外科,广州510080

出　　处：《实用医技杂志》2024年第6期399-403,共5页Journal of Practical Medical Techniques

基　　金：赣州市指导性科技计划项目(20222ZDX8584)。

摘　　要：目的探究CT三维重建辅助下精确定量法经椎弓根植骨联合伤椎置钉短节段固定治疗胸腰椎爆裂骨折的效果。方法选择2019年10月至2022年2月于我院接受治疗的60例胸腰椎爆裂骨折患者为研究对象,使用随机数字表法将患者分为观察组(30例)及对照组(30例),对照组患者采用常规手术方法伤椎置钉而不植骨,观察组患者术前使用Mimics软件对CT影像进行三维重建并测量,精确计算骨缺失量并进行椎弓根植骨联合伤椎置钉。比较2组术后1周、3个月、6个月、1年时疼痛及功能改善情况(Denis评分)、伤椎后凸角度、伤椎前缘高度比及伤椎缺损面积水平差异。结果术后3个月、6个月、1年时,2组患者疼痛及功能得分均较术后1周时降低,且术后6个月、1年时观察组患者疼痛及功能得分均低于对照组(P<0.05);术后3个月、6个月、1年时,2组患者伤椎后凸角度均较术后1周时上升,且观察组患者均低于对照组(P<0.05);术后1年时,观察组患者伤椎前缘高度比较术后1周时降低,术后3个月、6个月、1年时,对照组患者伤椎后凸角度均较术后1周时降低,且术后3个月、6个月、1年时观察组患者均低于对照组(P<0.05);术后3个月、6个月、1年时,观察组患者伤椎缺损面积均较术后1周时下降,术后1年时对照组患者伤椎缺损面积较术后1周时下降,且术后1周、3个月、6个月、1年时观察组患者均低于对照组(P<0.05)。结论CT三维重建辅助下精确定量法经椎弓根植骨联合伤椎置钉短节段固定治疗有助于胸腰椎爆裂骨折患者疼痛减轻及功能恢复,且能控制伤椎后凸角度、伤椎前缘高度比变化,降低伤椎缺损面积。Objective To investigate the effect of precise quantification using CT threedimensional reconstruction assisted transpedicular bone grafting combined with short segment fixation of injured vertebrae in the treatment of thoracolumbar burst fractures.Methods Sixty patients with thoracolumbar burst fractures who received treatment in our hospital from October 2019 to February 2022 were selected as the study subjects.The patients were randomly divided into an observation group(n=30)and a control group(n=30)using a random number table method.The control group patients were treated with conventional surgical methods to place screws on the injured vertebrae without bone grafting.The observation group patients were preoperatively reconstructed and measured using Mimics software for 3DCT images.Accurately calculate the amount of bone loss and perform pedicle bone grafting combined with vertebral instrumentation.Compare the differences in pain and functional improvement(Denis score),kyphosis angle,anterior edge height ratio,and defect area between the two groups at 1 week,3 months,6 months,and 1 year after surgery.Results At 3 months,6 months,and 1 year after surgery,the pain and function scores of both groups of patients decreased compared to 1 week after surgery,and the pain and function scores of the observation group were lower than those of the control group at 6 months and 1 year after surgery(P<0.05).At 3 months,6 months,and 1 year after surgery,the kyphosis angle of the injured vertebrae in both groups of patients increased compared to 1 week after surgery,and the observation group patients were lower than the control group(P<0.05).At 1 year after surgery,the height of the anterior edge of the injured vertebra in the observation group decreased compared to 1 week after surgery.At 3 months,6 months,and 1 year after surgery,the kyphosis angle of the injured vertebra in the control group decreased compared to 1 week after surgery,and at 3 months,6 months,and 1 year after surgery,the observation group patients were low

关 键 词：体层摄影术 X线计算机 胸椎 腰椎 爆裂骨折 椎弓根 植骨 

分 类 号：R687.3[医药卫生—骨科学]