后路钉棒系统内固定联合自体骨髓间充质干细胞移植治疗胸腰椎骨折合并脊髓损伤

摘要

Objective :To explore the curative effect of posterior pedicle screw fixation combination with autologous bone mesenchymal stem cells grafting for thoracolumbar fractures with spinal cord injury .Methods :From January 2006 to March 2014 ,60 cases of thoracolumbar fractures with spinal cord injury were randomly divided into control group and treatment group .Control group were treated by posterior pedicle screw fixation ,and treatment group were treated by posterior pedicle screw fixation combined with autologous bone mesenchymal stem cells grafting .Results:All pa‐tients were followed up from 10 to 25 (12 .4 ± 2 .3)months .There were no statistical difference of height of anterior or posterior vertebral body and Cobb’s angle at postoperation and the last test follow‐up between the two groups(P>0.05) .At final follow‐up ,acupuncture algesthesia ,light touch sensation ,exercise ,and MBI of all the patients were sig‐nificantly improved postoperation(P<0 .05) .The two groups of therapeutic effect was significant difference ,the treat‐ment group was better than in control group(P<0 .05) .Conclusion:It is safe and effective of posterior pedicle screw fixation combination with autologous bone mesenchymal stem cells grafting for thoracolumbar fractures with spinal cord injury .It can improve limb function of motor and sensory function of spinal cord injury .%目的：探讨后路钉棒系统内固定联合自体骨髓间充质干细胞移植治疗胸腰椎骨折合并脊髓损伤的方法和疗效。方法：选取本院2006年1月－2014年3月60例胸腰椎骨折合并脊髓损伤患者，随机分为对照组和治疗组，对照组采用单纯后路钉棒系统内固定治疗，治疗组采用后路钉棒系统内固定联合自体骨髓间充质干细胞移植治疗。结果：所有患者经过10～25（12．4±2．3）个月的随访，两组患者术后及末次随访时骨折椎体前后缘高度及Cobb角比较差异无统计学意义（P＞0．05），末次随访时两组痛觉、触觉、运动及改良Barthel指数（MBI）等各项评分均较术前明显提高（P＜0．05），其中治疗组各项评分优于对照组（P＜0．05）。结论：后路钉棒系统内固定联合自体骨髓间充质干细胞移植治疗胸腰椎骨折合并脊髓损伤，可明显改善脊髓损伤患者的运动和感觉功能，是一种安全、有效的治疗方法。