内固定椎板间植骨融合术治疗椎体终板骨软骨炎所致胸腰背部疼痛初步观察

Preliminary Observation of Bone Graft Fusion with Internal Fixation of Vertebral Plate in the Treatment of Chest Pain and Back Pain Caused By Vertebral End-Plate Osteochondritis

目的:研究椎体终板骨软骨炎致胸腰背部疼痛患者使用内固定椎板间植骨融合术治疗的临床效果。方法:临床纳入84例本院2012年4月-2014年4月收治的椎体终板骨软骨炎致胸腰背部疼痛的患者,将所有患者按入院顺序分为两组各42例。观察组行内固定椎板间植骨融合术,对照组行单纯髓核摘除术。观察两组患者治疗结果、胸腰椎功能情况,对所有患者进行1年随访观察,观察两组患者胸腰背部疼痛情况、并发症发生以及复发率情况等。结果:两组患者术前VAS评分、ODI评分比较,差异无统计学意义(P>0.05)。术后,观察组患者手术时间、术中出血量均低于对照组,VAS评分、ODI评分亦低于对照组,比较差异有统计学意义(P<0.05)。观察组并发症发生率、复发率分别为4.76%、2.38%,远低于对照组的21.43%、19.05%;观察组胸腰椎功能优良率高达90.48%,明显高于对照组的76.19%,比较差异具有统计学意义(P<0.05)。结论:椎体终板骨软骨炎患者采用内固定椎板间植骨融合术不仅手术时间短、出血量较少,还能缓解患者胸腰背部疼痛,术后并发症少,复发率低,明显改善患者胸腰椎功能,值得临床应用及推广。

Objective： To investigate the clinical application effect of bone graft fusion with internal fixation of vertebral plate in the treatment of chest pain and back pain that was caused by vertebral end-plate osteochondritis. Method： In the clinical practices, 42 patients with chest pain and back pain caused by vertebral end-plate osteochondritis treated from April 2012 to April 2014 in our hospital were selected. All the patients received the bone graft fusion with internal fixation of vertebral plate. The patient＇s treatment outcome and condition of chest pain and back pain was observed.Result： Preoperative vas and ODI score showed no difference between the two groups （ P〉0.05 ） .Postoperative operation time and intraoperative bleeding volume of the observation group was better than that of the control group, but postoperative VAS and ODI scores was lower, there was statistically significant difference （ P〈0.05 ） . The complication rate and recurrence rate of the observation group was 4.76%, 2.38%, respectively, which was lower than 21.43%, 19.05% of the control groups, excellent and good rate of thoracic lumbar function of the observation group was 90.48%, which was significantly higher than 76.19% of the control group, the difference was statistically significant （ P〈0.05 ） . Conclusion： For patients with vertebral end- plate osteochondritis, the bone graft fusion with internal fixation of vertebral plate can not 0nly relieve the patient＇s chest pain and back pain, but also improve the thoracolumbar spine function. It has a much favorable treatment effect. It is worthy of clinical application and promotion.