分析椎弓根固定联合脱钙骨基质材料复合自体骨植骨融合对胸腰段脊柱爆裂性骨折患者临床疗效及并发症影响

Analysis of the Clinical Efficacy and Complications of Pedicle Fixation Combined with Decalcified Bone Matrix Material and Autogenous Bone Graft Fusion on Patients with Thoracolumbar Burst Fractures

目的探讨椎弓根固定联合脱钙骨基质材料复合自体骨植骨融合治疗胸腰段脊柱爆裂性骨折(thoracolumbar burst fracture,TLBF)的临床疗效及对并发症的影响。方法选取该院自2016年1月—2021年1月期间收治入院并行手术治疗的TLBF患者48例,按照随机数字表法分两组,各24例,对照组予以椎弓根固定治疗,观察组予以椎弓根固定联合脱钙骨基质材料复合自体骨植骨融合治疗。观察效果及并发症。结果观察组术后1、3、6个月JOA评分分别为(22.39±3.09)分、(15.64±2.30)分、(10.35±1.94)分,低于对照组(24.84±3.11)分、(18.37±2.24)分、(13.88±1.76)分,差异有统计学意义(t=2.738、4.166、6.602,P<0.05)。术后6个月随访,观察组伤椎前缘高度(2.64±0.39)cm,伤椎中部高度(2.59±0.21)cm,高于对照组的(2.12±0.21)cm、(2.18±0.19)cm,差异有统计学意义(t=5.751、7.093,P<0.001);两组患者Cobb角均有所改善,且观察组Cobb角为(13.68±3.79)°,低于对照组(16.34±3.06)°,差异有统计学意义(t=2.675,P=0.010)。两组术后并发症总发生率差异无统计学意义(P>0.05)。结论椎弓根固定联合脱钙骨基质材料复合自体骨植骨融合治疗可促进伤椎前缘及中部高度恢复,有效改善术后胸腰椎功能,且术后并发症发生率低。

Objective To investigate the clinical efficacy of pedicle fixation combined with decalcified bone matrix material and autogenous bone graft fusion in the treatment of thoracolumbar burst fracture(TLBF)and its influence on complications.Methods A total of 48 TLBF patients with TLBF admitted to the hospital from January 2016 to January 2021 were selected and divided into two groups according to the random number table method,each with 24 cases.The control group was treated with pedicle fixation,and the observation group was treated with pedicle fixation combined with demineralized bone matrix material and autogenous bone graft fusion.Observed the effect and complications.Results The JOA scores of the observation group were(22.39±3.09)points,(15.64±2.30)points,and(10.35±1.94)points at 1 month,3 months,and 6 months after operation,which were lower than those of the control group(24.84±3.11)points,(18.37±2.24)points,(13.88±1.76)points,the difference was statistically significant(t=2.738,4.166,6.602,P<0.05).Follow-up 6 months after operation,the height of the anterior edge of the injured vertebrae in the observation group was(2.64±0.39)cm,and the height of the middle of the injured vertebrae was(2.59±0.21)cm,which were higher than those of the control group(2.12±0.21)cm and(2.18±0.19)cm,the difference was statistically significant(t=5.751,7.093,P<0.001);the Cobb angle of the two groups of patients improved,and the Cobb angle of the observation group was(13.68±3.79)°,which was lower than the control group(16.34±3.06)°,the difference was statistically significant(t=2.675,P=0.010).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Pedicle fixation combined with decalcified bone matrix material and autologous bone graft fusion can promote the recovery of the anterior and middle height of the injured vertebrae,effectively improve the postoperative thoracolumbar function,and have a low incidence of postoperative complications.