经椎弓根植骨治疗胸腰椎爆裂性骨折的随机多中心对照分析

Randomized Multi-center Control Analysis on Transpedicular Bone Grafting for Treatment of Thoracolumbar Burst Fracture

目的:探讨经椎弓根植骨治疗胸腰椎爆裂性骨折的应用价值。方法:选取2013年3月-2014年3月收治入本院的26例胸腰椎爆裂性骨折患者为研究对象,对其临床资料进行回顾性分析,比较术前、术后、随访时患者影像学评估、治疗效果、神经功能改善程度。结果:术后患者伤椎管狭窄程度、伤椎前缘压缩率、伤椎后缘压缩率分别为(9.2±3.7)%、(14.5±5.3)%、(11.3±4.7)%,明显低于术前的(59.4±5.9)%、(54.6±10.7)%、(46.9±8.6)%;术后患者脊柱Cobb’s角、椎体成角、上下终板成角分别为(8.3±3.7)°、(-3.6±1.4)°、(3.6±2.5)°,明显小于术前的(22.3±6.5)°、(-15.6±2.2)°、(14.6±3.2)°,比较差异均有统计学意义(P<0.05),且患者术后神经功能得到明显改善。结论:经椎弓根植骨治疗胸腰椎爆裂性骨折患者可明显提高治疗效果,改善患者生活水平,使身体恢复健康,值得临床推广使用。

Objective： To explore the application value of transpedicular bone grafting for treatment of thoracolumbar burst fracture. Method： 26 patients with thoracolumbar burst fracture admitted into the Hospital from March, 2013 to March, 2014 were selected as research subjects, whose clinical data were retrospectively analyzed, and preoperative and postoperative imaging evaluation, treatment efficacy and improvement degree of nerve function of patients during follow-ups were compared. Result： The degree of injured spinal stenosis, compression ratio of anterior injured vertebra and compression rate of posterior injured vertebra of postoperative patients hit （ 9.2 ±3.7 ）%, （ 14.5 ± 5.3 ） %, and （ 11.3 ± 4,7 ） %, respectively, being significantly lower than those preoperative indexes at （ 59.4 ± 5.9 ） %, （54.6 ± 10.7 ） %, and （ 46.9 ± 8.6 ） % respectively. Spine Cobh＇S angulation, vertebral angulation, upper and lower end plate angulation of postoperative patients hit （ 8.3 ± 3.7 ）°, .（ ,3.6 ± 1.4 ）° and （ 3.6 ± 2.5 ）°, being significantly less than （ 22.3 ±6.5 ）° and （ -15.6 ± 2.2 ）° and （ 14.6 ±3.2 ）° respectively before operation, comparative difference satisfied （ P〈0.05 ）, and postoperative nerve function of patients improved significantly. Conclusion： Ttranspedicular bone grafting treatment on patients with thoracolumbar burst fracture is capable of obviously improving the treatment efficacy, enhancing the life quality of patients , and recovering physical condition to the health, being worthy of clinical use and promotion.