经椎弓根椎体内植骨对胸腰椎骨折复位术后防止矫正度丢失的作用研究

摘要

Objective To explore the effect of vertebral body bone graft for preventing the loss of correction after thoracolumbar fracture. Methods Fifty cases of thoracic and lumbar fracture coincided with the criteria during January 2014 to June 2015 were included in this study. All these patients were treated by pedicle bone graft and they were followed up for 1 year. The following:items were performed:①Vertebral height rati-o had been recorded and compared with that of preoperation,postoperation and 1 year after the vertebral anterior and posterior margin height ratio.②The relative area of bone mass and bone defect were recorded and compared in 6 months and 1 year after the operation. Results ①Vertebral height ratio at preoperation,immediate postoperation and 1 year after the operation,the front edge of vertebral body (F = 1802. 99,P < 0. 01), trailing edge (F = 69. 50,P < 0. 01)and height ratio were significantly different. The ratio of vertebral front height decreased by 0. 34%,and the height of trailing edge was decreased by 0. 26%,but the difference was not significant (t = 0. 80,P = 0. 43). ②Relative area of bone block was fallen from 11. 65% down to 37. 81% in 1 year after the operation,and It had significant difference (F = 310. 79,P < 0. 01). ③Only 17 patients had obvious bone defect after follow - up for 1 year,it was decreased from 22. 73% to 8. 22 % in 1 year after the operation,and the de-crease was obvious with significant difference (F = 12. 18,P < 0. 01). Conclusion The bone graft can be applied to restore the integrity and stability of the original bone mass,but it can not restore the void of vertebral bodies.%目的 探讨经椎弓根椎体内植骨对胸腰椎骨折复位术后防止矫正度丢失的作用.方法 选取2014年1月至2015年6月期间收治的符合纳入标准的胸腰椎骨折患者50例.所有患者均行经椎弓根椎体内植骨术,并随访1年.做以下处理:①椎体高度比:记录并对比患者术前、术后即刻以及术后1年的椎体前、后缘高度比.②记录并对比术后即刻、术后6个月以及术后1年的植入骨块、骨缺损相对面积.结果 ①椎体高度比:术前、术后即刻以及术后1年的椎体前(F=1802.99,P<0.01)、后缘(F=69.50,P<0.01)高度比均有明显差异;椎体前缘高度比下降了0.34%,后缘高度下降了0.26%,前后缘差异无显著性(t=0.80,P=0.43).②植入骨块相对面积:由术后即刻的37.81%下降至术后1年的11.65%,差异有显著性(F=310.79,P<0.01).③骨缺损相对面积:随访1年后,仅17例有较明显的骨缺损,其由术后即刻的22.73%下降至术后1年的8.22%,下降幅度大,差异有显著性(F=12.18,P<0.01).结论经椎弓根椎体内植骨治疗胸腰椎骨折可以较好地恢复原有骨块的完整性和稳定性,但无法使椎体内空隙恢复.