经伤椎椎弓根植骨加椎弓根螺钉用于脊柱胸腰段爆裂性骨折的临床观察

Clinical analysis of pedicle bone graft and pedicle screw fixation for thoracolumbar burst fractures

目的研究并探讨经伤椎椎弓根植骨加椎弓根螺钉用于脊柱胸腰段爆裂性骨折临床治疗中的应用效果。方法将2014年1月~2017年1月期间符合纳入标准的100例脊柱胸腰段爆裂性骨折患者纳入研究,根据患者接受的手术类型为2组,50例/组,对照组实施外侧植骨加椎弓根螺钉内固定治疗,观察组实施经伤椎椎弓根植骨加椎弓根螺钉内固定治疗,比较两组患者的手术时间、术中出血量、疼痛评分、后凸角度、伤椎高度、脊髓神经损伤分级。结果两组患者的手术时间、术中出血量比较无统计学差异(P>0.05);两组患者手术后的疼痛评分均较手术前显著降低(P<0.05),其伤椎前缘高度和后缘高度均较手术前显著增高(P<0.05),其后凸角度均较手术前显著减小(P<0.05),而在手术后,观察组的疼痛评分低于对照组(P<0.05),其伤椎高度高于对照组(P<0.05),后凸角度小于对照组(P<0.05);脊髓神经损伤分级方面,手术后,观察组中Frankel分级为E级的患者多于对照组(P<0.05)。结论在脊柱胸腰段爆裂性骨折患者治疗中,应用经伤椎椎弓根植骨加椎弓根螺钉内固定治疗方案,可有效减轻疼痛,纠正伤椎高度和后凸角度,有利于促使脊髓神经损伤有效恢复。

Objective To observe the clinical effect of pedicle bone graft and pedicle screw in thetreatment of thoracolumbar burst fracture. Methods From January 2014 to January 2017,100 patientswith thoracolumbar burst fracture were divided into two groups（50 cases per group）. The patients in thecontrol group were treated with lateral bone grafting plus pedicle screw fixation,and the observation groupwere treated with pedicle bone graft and pedicle screw internal fixation. The operative time,intraoperativebleeding volume,pain score,kyphosis angle were compared between the two groups. The height of injuredvertebrae and the grade of spinal cord nerve injury. Results There was no significant difference inintraoperative bleeding volume between the two groups（P〉0.05）. The pain scores of the two groups weresignificantly lower than those before operation（P〈0.05）,and the anterior and posterior edge height ofinjured vertebrae were significantly higher than those before operation（P〈0.05）,and the kyphosis anglewas significantly higher than that before operation（P〈0.05）. The pain score of the observation group waslower than that of the control group（P〈0.05）,and the height of the injured vertebrae was higher than thatof the control group（P〈0.05）,and the kyphotic angle was lower than that of the control group（P〈0.05）.Conclusion In the treatment of thoracolumbar burst fracture,the treatment with pedicle bone graft andpedicle screw fixation can effectively reduce the pain and correct the height and kyphosis angle of injuredvertebrae. It is beneficial to promote the effective recovery of spinal cord nerve injury.