经伤椎椎弓根植骨与不植骨联合内固定术治疗对腰椎骨折患者伤椎高度丢失的影响分析

Effect of transpedicular Bone Graft and Non-bone Graft through the in⁃jured vertebra Combined with Internal Fixation on Vertebral Height Loss in Patients with Lumbar Fracture

目的探究在腰椎骨折的临床治疗中,经伤椎椎弓根植骨与不植骨联合内固定术的应用效果。方法回顾性选取2022年10月—2023年10月福州市第二医院收治的60例腰椎骨折手术患者的临床资料,按照术中有无经伤椎椎弓根植骨分为对照组和研究组,各30例。对照组采用后路经伤椎椎弓根置钉内固定,研究组采用后路经伤椎椎弓根植骨联合置钉内固定,对比两组患者的临床疗效、脊柱状态、腰椎功能、日常生活能力及并发症发生情况。结果研究组治疗优良率为93.33%(28/30),高于对照组的70.00%(21/30),差异有统计学意义(χ^(2)=5.455,P<0.05)。术后12个月,研究组伤椎前缘高度、伤椎楔形角大于对照组,后凸Cobb角、椎管狭窄率、椎体前缘压缩率均小于对照组,差异有统计学意义(P均<0.05)。术后12个月,研究组日本骨科协会评估量表和巴塞尔指数评价表评分均高于对照组,差异有统计学意义(P均<0.05)。研究组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论在腰椎骨折的临床治疗中,后路经伤椎椎弓根植骨联合置钉内固定能够促进患者术后腰椎功能恢复,改善伤椎高度丢失,并减轻创伤应激和疼痛刺激,降低并发症发生风险,提高康复效率,改善预后,实用性和安全性更高。

Objective To explore the application effect of transpedicular bone grafting and non-bone grafting com⁃bined with internal fixation in the clinical treatment of lumbar fracture.Methods From October 2022 to October 2023,60 patients with lumbar spine fracture surgery admitted to Fuzhou Second Hospital were retrospectively selected the clinical data of the research objects.They were divided into control group and study group according to the presence or absence of transpedicular bone grafting in the operation,with 30 cases in each group.The control group was treated with posterior vertebral pedicle screw fixation,and the study group was treated with posterior vertebral pedicle bone graft combined with screw fixation.The clinical efficacy,spinal status,Lumbar function,daily living ability and coc⁃currence of complications of two groups were compared.Results The excellent and good rate of treatment in the study group was 93.33%(28/30),which was higher than 70.00%(21/30)in the control group,and the difference was statisti⁃cally significant(χ2=5.455,P<0.05).At 12 months after operation,the height of the anterior edge of the injured verte⁃bra and the wedge angle of the injured vertebra in the study group were higher than those in the control group,and the kyphosis Cobb angle,spinal stenosis rate and compression rate of the anterior edge of the vertebral body were lower than those in the control group,and the differences were statistically significant(all P<0.05).At 12 months after opera⁃tion,the Japanese Orthopaedic Association Scores and Brathel Index scores of the study group were higher than those of the control group,and the differences were statistically significant(both P<0.05).The total incidence of postopera⁃tive complications in the study group was lower than that in the control group,and the difference was statistically sig⁃nificant(P<0.05).Conclusion In the clinical treatment of lumbar fracture,posterior transpedicular bone grafting com⁃bined with pedicle screw fixation can promote the recovery of lumbar function,improve the loss of vertebral height,re⁃duce traumatic stress and pain stimulation,reduce the risk of complications,improve the efficiency of rehabilitation,improve the prognosis,and have higher practicability and safety.