经椎弓根椎体内植骨联合短节段内固定治疗老年骨质疏松性脊柱骨折的临床疗效

Curative Effect of Transpedicular Intervertebral Bone Graft after Posterior Pedicle Screw Fixation of Thoracolumbar Fractures in Senile-osteoporotic Vertebral Fracture Patients

目的:探讨使用椎弓根椎体内植骨联合短节段内固定法治疗老年骨质疏松性脊柱骨折的临床疗效。方法:将2013年2月至2013年10月入院的59例老年胸腰段脊柱骨折患者按照治疗方法分为两组:观察组27例,进行经椎弓根椎体内植骨联合短节段弓根钉棒系统内固定治疗;对照组32例,单纯进行短节段弓根钉棒系统内固定治疗。研究过程中对患者的术中失血量、手术所用时间、VAS、手术前后椎体高度、骨折愈合时间及住院时间等治疗进行记录,并对两组数据进行统计学分析。结果:观察组术后及末次随访椎体高度丢失明显低于对照组(4.31±2.86<7.13±4.41,4.72±3.98<11.57±4.72,P<0.05),术前Cobb角两组患者无差异,而术后及末次随访Cobb角观察组明显低于对照组(3.96±3.47<7.25±5.29,5.17±4.33<11.21±6.29,P<0.01),差异均有统计学意义(P<0.05)。术后疼痛程度评分显示,对照组高于观察组(5.68±2.37>1.86±1.41,P<0.05),有显著性差异。观察组术后内固定物失效率也明显低于对照组(P<0.05)。结论:临床调查结果显示,使用椎弓根椎体内植骨联合短节段内固定治疗老年骨质疏松性脊柱骨折可降低术后痛感,提高固定即时稳定性,值得临床推广使用。

Objective： To discuss the clinical curative effect of the treatment of transpedicular intervertebral bone graft after posterior pedicle screw fixation of thoracolumbar fractures in senile-osteoporotic vertebral fracture patients. Methods： Fifty-nine patients of thoracolumbar fractures in senile-osteoporotic in our hospital between February 2013 and October 2013 were seleced and divided into two groups according to the operation methods they recieved（27 cases of vertebrae pedicle bone graft combined withposterior pedicle screw fixation as observation group and 32 cases of single posterior pedicle screw fixation as control group）. Results： The vertebral height loss in observation group was significantly lower than those in control group（4.31±2. 867.13±4.41, 4.72±3.9811.57±4.72, P〈0.05）.Cobb angle showed no statistical difference before the operation, but was lower than those in control group after the operation（3.96±3.477.25±5.29, 5.17±4.3311.21±6.29, P〈0.05）. In addition, patients in observation group had significantly less pain degree（5.68±2.371.86±1.41, P〈0.05）, and the faulting rate of internal fixation were significantly lower than the control group（P〈0.05）. Conclusion：Results showed that the treatment of transpedicular intervertebral bone graft after posterior pedicle screw fixation can reduce pain degree and improve the immediate stabilization of the fusedsegment. It is worthy of being widely used in clinic.