椎体内植骨对Denis B型胸腰椎骨折患者术后椎骨缺损的影响

The effect of vertebral body bone graft for Denis type B vertebral defect postoperatively in patients with thoracolumbar fractures

目的:研究短节段椎弓根螺钉固定辅助椎体内植骨对预防Denis B型胸腰椎骨折术后矫正度丢失及伤椎骨缺损的效果。方法:选取60例Denis B型胸腰椎骨折患者,根据患者是否进行伤椎内植骨将其分为伤椎内植骨组和未植骨组,每组30例。统计两组术后伤椎前缘高度压缩率、手术前后脊柱后凸角度(Cobb角),且在术后统计伤椎骨的CT横断位的缺损程度及位置,并进行统计分析。结果:植骨组术前Cobb角和术后一周时的Cobb角比较具有显著性差异(t=7.139,P<0.001);且术前Cobb角和末次随访时的Cobb角比较也具有显著性差异(t=2.189,P=0.033)。未植骨组术前Cobb角和术后一周时的Cobb角比较具有显著性差异(t=6.685,P<0.001),且术前Cobb角和末次随访时的Cobb角比较也具有显著性差异(t=2.473,P=0.016)。两组患者的CT横断位骨缺损分布无显著性差异(x^2=0.754,P=0.861),而椎骨缺损的程度比较具有显著性差异(t=-5.457,P<0.001)。结论:短节段椎弓根螺钉固定辅助椎体内植骨对预防Denis B型胸腰椎骨折术后矫正度丢失及伤椎骨缺损的效果良好,可以有效矫正伤椎前缘高度以及Cobb角,并降低伤椎的缺损程度。

Objective： To analyze the effect of short segmental pedicle screw fixation auxiliary vertebral body bone graft for preventing Denis type B thoracolumbar fractures postoperative degree of loss and injured vertebral defect. Methods： We selected 60 patients with Denis type B thoracolumbar fractures as the research objects, to analyse its reset via short segmental pedicle screws fixed postoperative imaging data. According to whether patients with vertebral bone graft, we divided 60 patients into injury in the vertebral bone graft and bone graft group, each group with 30 cases. Finally, we counted patients in postoperative wound vertebral front high compression rate, Cobb angle and intervertebral height before and after operation. Results： There is significant difference in Cobb angle between preoperative and one week postoperative in bone graft group（t=7.139, P〈0.001）. And Cobb angle in preoperative and at the time of the last follow-up is also has significant difference in bone graft group（t=2.189, P=2.189）. There is significant difference in Cobb angle between preoperative and one week postoperative in no bone graft group（t=6.685, P〈0.001）. And Cobb Angle in preoperative and at the time of the last follow-up is also has significant difference in no bone graft group（t=2.473, P=0.016）. Conclusion： The effect of short segmental pedicle screw fixation auxiliary vertebral body bone graft for preventing Denis type B thoracolumbar fractures pastoperative loss degree and vertebral defect is good. And the method can effectively correct the injured vertebra leading edge height and Cobb angle, and reduce the degree of injury of the vertebral defect.