前路减压并钛网植骨内固定术对胸腰椎爆裂性骨折神经功能及椎体形态的影响研究

Study on the In? uence of Anterior Decompression Combined with Internal Fixation by Titanium Mesh Bone Grafting for the Nerve Function and Vertebral Morphology of Patients with Thoracic and Lumbar Burst Fractures

目的:研究分析前路减压并钛网植骨内固定术对胸腰椎爆裂性骨折患者神经功能及椎体形态的影响。方法:选取2009年4月-2011年7月于笔者所在医院进行治疗的46例胸腰椎爆裂性骨折患者为研究对象,将其随机分为对照组(椎弓根螺钉内固定组)和观察组(前路减压并钛网植骨内固定术组),每组各23例,将两组患者术前及术后3个月、6个月的ASIA评分、血清NSE、S100B、SOD、MDA水平及椎体形态指标进行统计及比较。结果:观察组治疗后3个月及6个月的ASIA评分D～E级比例高于对照组,血清NSE、S100B及MDA水平均低于对照组,SOD高于对照组,椎体形态指标改善幅度大于对照组(均P<0.05)。结论:前路减压并钛网植骨内固定术对胸腰椎爆裂性骨折患者神经功能及椎体形态的影响更为突出,对于胸腰椎形态的改善发挥着积极的作用。

Objective：To study and analyze the influence of anterior decompression combined with internal fixation by titanium mesh bone grafting for the nerve function and vertebral morphology of patients with thoracic and lumbar burst fractures.Methods：46 patients with thoracic and lumbar burst fractures in our hospital from April 2009 to July 2011 were selected as research object,and they were randomly divided into control group（pedicle screw internal fixation group）and observation group（anterior decompression combined with internal fixation by titanium mesh bone grafting group）with 23 cases in each group,then the ASIA score,serum NSE,S100B,SOD,MDA and indexes of vertebral morphology of two groups before and after the operation at third and sixth month were analyzed and compared.Results：The D to E rate of observation group for ASIA score after the operation at third and sixth month were higher than those of control group,serum NSE,S100B and MDA were lower than those of control group,SOD were higher than those of control group,improvement range of vertebral morphology indexes were bigger than those of control group（all P〈0.05）.Conclusion：The influence of anterior decompression combined with internal fixation by titanium mesh bone grafting for the nerve function and vertebral morphology of patients with thoracic and lumbar burst fractures is obvious,and it plays an active role in improving the vertebral morphology.