经椎弓根和经椎管单侧椎体内植骨的植骨分布状况与骨折愈合的疗效观察

Effect of Transpedicular and Unilateral Vertebral Bone Grafting on Bone Grafting Distribution and Fracture Healing

目的探讨胸腰椎骨折采用经椎弓根和经椎管单侧椎体内植骨结合椎弓根钉棒内固定治疗的疗效。方法选取68例于2014年5月—2015年5月我院接收的单椎体新鲜骨折患者,根据植骨路径不同分为经椎弓根植骨组(n=34)和经椎管植骨组(n=34),对患者术后椎体内植骨分布区域、百分比及术前术后矢状面指数(SI)、椎体后凸Cobb角进行比较。结果经椎管组在植骨面积上大于经椎弓根植骨组(P<0.05),可认为其植骨区域优于经椎弓根植骨组;两组术后各时间点SI值、Cobb角与术前比较具有明显差异性(P<0.05),而术后各时间点上述指标比较无统计学意义,且两组间SI、Cobb角在不同时间点比较亦无明显差异性(P>0.05)。结论胸腰椎骨折采取经椎管植骨或经椎弓根通道植骨结合椎弓根钉棒系统内固定均能取得有效疗效,故在不同骨折类型时应给予个性化治疗方案,达到治疗和有效降低损伤的目的。

Objective To investigate the curative effect of the adoption of transpedicular and unilateral vertebral bone grafting combined with pedicle screw fixation therapy for thoracolumbar vertebral fracture. Methods 68 patients with single vertebral body fractures admitted in our hospital from May 2014 to May 2015 were selected. According to the differences of bone path, they were divided into transpedicular bone graft group （n=34） and the vertebral bone graft group （n=34） to compare the postoperative distribution of bone graft area, the percentage, preoperative, postoperative sagittal plane index （SI） and Cobb angle of vertebral body posterior. Results the bone graft area of the vertebral canal group was greater than that of the pedicle bone grafting group （P〈0.05）, and it can be deemed that the bone graft area was better than transpedicular bone grafting group; After the operation, the SI value and Cobb angle of two groups showed obvious difference compared with those before operation （P〈0.05）, and the above mentioned indexes of each time point after operation was not statistically significant between the two groups, and the comparison of SI and Cobb angle at different time points also had no significant difference in the two groups （P〉0.05）. Conclusion The adoption of transpedicular and unilateral vertebral bone grafting combined with pediele screw fixation therapy have an curative effect on thoracolumbar vertebral fracture so individualized treatment should be given in different types of fractures to achieve the purpose of treatment and to effectively reduce the damage.