椎弓根固定联合可诱导冻干脱钙骨复合自体骨植骨融合对TLBF的近远期效果分析

The Short-Long-Term Effect of Pedicle Fixation and Induced FreezeDried Decalcified Bone Granules Combined Autogenous Bone Graft Fusion on Burst Fracture of Thoracolumbar Spine

目的探讨胸腰段脊柱爆裂性骨折(TLBF)应用椎弓根固定与可诱导冻干脱钙骨颗粒(DBM)复合自体骨植骨融合(ABGF)联合治疗的远近期效果。方法回顾性分析2017年1月-2018年8月长江航运总医院收治的且至少随访1年以上的TLBF 76例患者临床资料,根据治疗方法不同分为观察组与对照组,其中接受椎弓根固定治疗36例为对照组,而加用可诱导冻干DBM复合ABGF联合治疗的40例为观察组。评价术后1个月、6个月、12个月时JOA评分,调查术前、术后6个月、术后12个月时Cobb角、伤椎前缘高度、伤椎中部高度,记录并发症,并比较。结果观察组术后1个月、6个月、12个月时JOA评分明显低于对照组(P<0.05);组间术前Cobb角、伤椎前缘高度、伤椎中部高度对比均无显著差异(P>0.05),术后6个月、12个月时观察组Cobb角更低,而伤椎前缘与中部高度更高,与对照组差异显著(P<0.05);两组并发症率无显著差异(P>0.05)。结论TLBF应用椎弓根固定与DBM复合ABGF联合治疗,相比单纯椎弓根固定治疗,可减少并发症发生,更好地改善JOA评分,以及Cobb角、伤椎高度,值得应用。

Objective To explore the the short-long-term effect of pedicle fixation and induced freeze-dried decalcified bone granules(DBM)combined autogenous bone graft fusion(ABGF)on burst fracture of thoracolumbar spine(TLBF).Methods Retrospective analysis of clinical data of 76 patients with TLBF treated at Changjiang Shipping General Hospital from January 2017 to August 2018 was conducted.The patients were followed by at least 1 year or more and were divided into observation group and control group according to the different treatment methods,36 cases of control group were subjected to pedicle fixation treatment.The 40 cases of observation group combined treatment of DBM and ABGF.JOA score of 1 month,6 months,12 months after surgery,Cobb angle,height of anterior edge of injured vertebra,height of middle edge of injured vertebra and complications before surgery,6 months after surgery,12 months after surgery were recorded and compared.Results JOA scores were significantly lower than that of the control group(P<0.05)at 1 month,6 months and 12 months after surgery in the observation group,and there were no significant differences in the preoperative Cobb angle,the height of anterior edge of injured vertebra and height of middle edge of injured vertebra(P>0.05),and the cobb angle in observation group was lower at 6 months,12 months after surgery,the height of anterior and middle edge of injured vertebra were higher,and the difference were significant different from those of the control group(P<0.05),and the complication rate of the two groups was not significant different(P>0.05).Conclusion Compared with pedicle fixation treatment,pedicle fixation and DBM combined ABGF combination therapy applied to TLBF can reduce the occurrence of complications,better improve the JOA score,as well as Cobb angle,height of injured vertebra.