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两种植骨方式治疗胸腰段脊柱骨折脱位疗效观察 被引量:5

CLINICAL EFFICACY OF TWO GROWING BONE IN THE TREATMENT OF THORACOLUMBAR SPINAL FRACTURE AND DISLOCATION
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摘要 目的:观察经椎间孔椎体间植骨与单纯后外侧植骨治疗胸腰段脊柱骨折脱位的效果。方法回顾分析该院2010年12月—2013年6月收治的胸腰段脊柱骨折脱位患者33例为研究对象,根据植骨方式分为经椎间孔椎体间植骨(TLIF 组)和单纯后外侧植骨组(PLF 组),治疗结束后对比手术时间、出血量、病死率、脊柱融合率、并发症发生率、神经功能恢复情况、Cobb 角恢复情况和椎体高度恢复情况,评价两种植骨方式的优劣。结果TLIF 组手术时间、术中出血量高于 PLF 组(P 〈0.05);两组患者的病死率、并发症发生率均为0;随访10~22个月,脊柱骨性融合率 TLIF 组高于 PLF 组(P 〈0.05);术后3个月随访神经功能恢复情况组间比较(P〉0.05);椎体高度恢复情况和 Cobb 角恢复情况组间比较(P 〉0.05)。结论经椎间孔椎体间植骨与单纯后外侧植骨两种植骨方式,前者能够获得更理想的脊柱骨性融合率,但手术时间较长,术中出血量较大。在临床上,如果患者的身体状况允许,最好选择经椎间孔椎体间植骨治疗胸腰段脊柱骨折脱位。 Objective To study the effect of transforaminal lumbar interbody bone grafting and simple pos-terior bone grafting for the treatment of thoracolumbar spinal fracture and dislocation.Methods Thirty-three cases of chest waist segment spine fracture dislocation admitted from December 2010 June 2013 were analyzed retrospectively.They were divided into transforaminal lumbar interbody bone grafting (TLIF group)and simple posterior bone grafting (PLF group)according to planting bone ways.After treatment, the surgery time,bleeding volume,mortality,spine fusion rate,complications,neural function recovery, cobb angle recovery and vertebral body height recovery were evaluated between two planting bone ways. Results The surgery time and amount of bleeding were higher in TLIF group than that in PLF group (P 〈0.05),but their mortality and complication rates were all 0.With 10~22 months of follow-up,spinal fu-sion rate of TLIF group was better than PLF group (P 〈0.05),but there were no statistical defference be-tween the two groups in neurological function recovery after operation and recovery of the vertebral height and cobb angle for 3-months follow-up (P 〉0.05).Conclusions In clinical practice,if the patient's con-dition is allows,transforaminal lumbar interbody bone grafting may be the best choice for the treatment of thoracolumbar spinal fracture and dislocation.Its shortcoming is the long operation time and larger intra-operative blood loss.
作者 刘桂峰
出处 《中国煤炭工业医学杂志》 2015年第4期605-608,共4页 Chinese Journal of Coal Industry Medicine
关键词 骨折脱位 胸腰段脊柱 后路手术 植骨方式 Thoracolumbar spinal fracture and dislocation Posterior operation Bone graft
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