胸腰椎爆裂骨折椎弓根螺钉内固定后椎管内骨块吸收回纳的影响因素分析

Analysis of influencing factors of absorption and recovery of bone in spinal canal after pedicle screw fixation for thoracolumbar burst fracture

目的探讨胸腰椎爆裂骨折经椎弓根螺钉内固定后椎管内骨块吸收回纳的相关因素。方法纳入2017年6月~2018年6月本院收治的80例胸腰椎爆裂骨折患者,均采用椎弓根螺钉内固定治疗,术前、术后7 d、术后6个月进行CT检查,计算椎管内骨块复位率以及再吸收率,用以观察骨块吸收回纳情况。纳入性别、年龄、骨折分型等病历资料,采用多元回归分析探讨术后椎管内骨块吸收回纳的影响因素。结果80例患者术后椎管内骨块平均复位率(44.87±3.98)%,平均再吸收率(70.87±5.98)%;不同椎体压缩率、骨折分型患者的椎管内骨块复位率以及再吸收率差异有统计学意义(P<0.05),不同年龄、性别、手术入路、Cobb角恢复率、伤椎置钉者的椎管内骨块复位率以及再吸收率差异无统计学意义(P>0.05);多元回归分析显示,椎体压缩率、骨折分型均为胸腰椎爆裂骨折椎弓根螺钉内固定后椎管内骨块复位率以及再吸收率的影响因素(P<0.05)。结论胸腰椎爆裂骨折椎弓根螺钉内固定后椎管内骨块能得到较好的吸收回纳与椎管重塑,但术前椎体压缩率以及骨折分型对术后椎管内骨块吸收回纳具有明显影响。

Objective To study the correlative factor of absorption and recovery of bone in spinal canal after pedicle screw fixation for thoracolumbar burst fracture.Methods Eighty patients with thoracolumbar burst fractures treated in our hospital from June 2017 to June 2018 were included into this study.All patients underwent pedicle screw fixation.CT examination was performed before surgery,7 days after surgery,and 6 months after surgery.The reduction rate and resorption rate of the bone in the spinal canal were used to observe the absorption and return of the bone,and the medical records such as gender,age and fracture classification were included.Multivariate regression analysis was used to investigate the vertebral screw internal fixation of the thoracolumbar burst fracture and influencing factors of bone reduction rate and resorption rate in the tube.Results Of 80 cases of with thoracolumbar burst fractures after pedicle screw internal fixation,the average reduction rate of intraspinal bone mass was(44.87±3.98)%,the average resorption rate was(70.87±5.98)%,%.Patients with different vertebral compression rate,fracture classification had statistically significant differences in the reduction rate of internal bone mass and resorption rate(P<0.05).Different age,gender,surgical approach,recovery rate of Cobb angle had no significant differences in the bone replacement rate of spinal canal and resorption(P>0.05).Multiple regression analysis showed that the compression rate and fracture classification of the vertebral body were the influencing factors of the reduction rate and resorption rate of the spinal canal after pedicle screw fixation(P<0.05).Conclusions Thoracolumbar burst fractures after pedicle screw fixation can obtain better absorption and return and spinal remodeling,but the preoperative vertebral compression rate and fracture classification have significant impact on absorption and recovery of bone in spinal canal after pedicle screw fixation.