摘要
目的探讨后路椎弓根螺钉内固定联合椎弓根及后外侧植骨在腰椎爆裂性骨折患者治疗中的应用及其效果。方法选取72例于2013年4月至2016年2月诊治的单节段腰椎(T11~L2)爆裂性骨折患者,随机分为研究组和对照组各36例,对照组给予传统后路椎弓根螺钉内固定治疗,研究组采用后路椎弓根螺钉内固定联合椎弓根及后外侧植骨治疗。术后1个月对比手术前后两组患者的后凸畸形角(Cobb角)变化及受损椎体高度情况,比较治疗后两组神经功能Frankel分级变化及骨融合情况;进行8个月随访,对比并发症发生情况。结果术后1个月评价,手术后两组患者的脊柱Cobb角度数均较手术前显著降低(P均<0.01),且研究组显著低于对照组(P<0.01);两组患者的受损椎体前缘高度比值及后缘高度比值均较手术前显著升高(P均<0.01),且研究组均显著高于对照组(P均<0.01);两组患者治疗后神经功能Frankel分级比较差异无统计学意义(Z=0.403,P=0.687);研究组患者治疗后骨融合率(100.00%)显著高于对照组的16.67%(χ~2=51.426,P=0.000)。随访8个月评价,研究组患者并发症发生率(5.56%)较对照组的22.22%显著降低(χ~2=4.181,P=0.041)。结论采用后路椎弓根螺钉内固定联合椎弓根及后外侧植骨治疗腰椎爆裂性骨折,能够显著降低Cobb角,提高受损椎体前缘高度比值、后缘高度比值及骨融合率,减少并发症。
Objective To investigate the application and effect of posterior pedicle screw fixation combined with pedicle and posterolateral bone graft in the treatment of lumbar burst fracture. Methods Seventy-two patients with lumbar burst fracture who received diagnosis and treatment from April 2013 to February 2016 were divided into study group and control group （36 patients in each group）. The control group patients received traditional posterior pedicle screw fixation, and the study group patients received posterior pedicle screw fixation combined with pedicle and posterolateral bone graft. The kyphosis angle （Cobb angle ） and the height of damaged vertebral body were compared between the two groups preoperatively and postoperatively （one month after the operation）. The changes of Frankel grading and bone fusion were compared between the two groups after the operation. A follow-up of 8 months was performed to compare the incidence of complications in two groups. Results One month after the operation, the Cobb angle of the two groups were significantly lower than that before the operation （all P 〈 0.01 ） , and the Cobb angle of study group was significantly lower than that of the control group after the operation （P 〈 0.01 ）. The ratio of anterior height and posterior height of damaged vertebral body in two groups were significantly higher than those before the operation （ all P 〈 0.01 ）, and the two ratios in the study group were significantly higher than those in the control group （ all P 〈 0. 01 ）. After the operation, the nervous function Frankel grading in two groups was no difference （Z = 0. 403, P = 0. 687 ）. The bone fusion rate in study group was higher than that in control group （100.00% vs 16.67% ,χ^2 = 51. 426, P = 0. 000 ）. After an 8-month follow-up, the complication rate in study group was lower than control group （5.56% vs 22.22% ,X2 = 4.181 ,P = 0. 041 ）. Conclusions For the treament of lumber burst fracture,posterior pedicle screw fixation combined with pedicle and posterolateral bone graft can reduce the Cobb angle, increase the radio of the anterior and posterior height of＇damaged vertebral body, as well as in bone fusion rate, and reduce the occurrence of complicaitons.
出处
《中国临床研究》
CAS
2018年第1期43-46,共4页
Chinese Journal of Clinical Research
