后路经伤椎椎弓根椎体内植骨治疗腰椎骨折的疗效分析

Therapeutic effect of bone grafting through posterior vertebral pedicle for lumbar fractures

背景:跨伤椎后路复位内固定术是治疗腰椎骨折较常用的手术方式。但术后易出现后凸畸形复发及内固定断裂等并发症。目的:探讨后路经伤椎椎弓根椎体内植骨治疗腰椎骨折的疗效分析。方法:选取我院2014年6月至12月收治的后路经伤椎椎弓根椎体内植骨治疗腰椎骨折患者45例,设为观察组;选取同期收治的采用传统跨伤椎椎弓根内固定术治疗的腰椎骨折患者40例,设置为对照组,比较两组患者的手术情况、医疗费用、术后并发症以及手术治疗效果。结果:观察组的手术时间长于对照组,医疗费用少于对照组,差异有统计学意义(P<0.05)。两组的术中出血量无统计学意义(P>0.05)。观察组的术后并发症少于对照组,术后6个月、12个月的伤椎前缘高度维持、伤椎高度百分比、Cobb角大于对照组,疼痛评分低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05)。结论:后路经伤椎椎弓根椎体内植骨治疗腰椎骨折能够有效维持伤椎三柱稳定性,减少并发症,促进脊椎功能恢复,是一种安全可靠的治疗方法。

Background： Intervertebral posterior reduction and internal fixation is a popular surgical method for the treatment of lumbar fractures. However, the recurrence of kyphosis and breakage of internal fixation sometimes occur after the operation. Objective： To investigate the therapeutic effect of posterior vertebral pedicle bone grafting for lumbar fractures. Methods： In this retrospective study, 45 patients with lumbar fractures treated by bone grafting through posterior vertebral pedicle beween June 2014 and December 2014 were enrolled into observation group, meanwhile, 40 patients with lumbar fractures underwent traditional intervertebral posterior reduction and internal fixation were assigned in control group. Intra operative conditions, medical cost, postoperative complications and clinical outcomes were compared between the two groups. Results： The observation group had longer operation time, less medical cost and lower postoperative rate of compli cations than control group （P〈0.05）. There was no significant difference in the intraoperative blood loss between the two groups （P〉0.05）. However, there were significant differences in terms of the height maintenance of the anterior injured vertebra, height percentage of the injured vertebra, Cobb angle, VAS score and JOA score between the two groups （P〈0.05）. Conclusions： Posterior vertebral pedicle bone grafting is a safe and reliable method for the treatment of lumbar fractures, which can effectively maintain the stability of three columns, reduce complications and promote spinal function recovery.