椎体加椎间植骨融合治疗胸腰椎爆裂性骨折的效果

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1、椎体加椎间植骨融合治疗胸腰椎爆裂性骨折的效果［摘要］目的探讨椎体加椎间植骨融合方式治疗胸腰椎爆裂性骨折的效果。方法选择2012年4月〜2013年2月三峡大学人民医院收治的胸腰椎爆裂性骨折患者90例作为研究对象，采用随机数字表法将患者分为观察组和对照组，各45例。确诊后即对两组患者实施后路一期开放腹围短接段内固定方案治疗，在上述手术的基础上对照组患者采用后外侧植骨融合方式进行治疗，观察组患者采用椎体加椎间植骨融合方式进行治疗。观察两组患者的手术情况，包括手术时间、术中出血量。随访2年，观察患者术后即刻及末次随访时伤椎Cobb角变化，末次随访时采用Anjarwal1a法

2、评价患者的骨性融合情况，并通过Frankel分级评价患者术后的神经功能恢复情况。结果两组手术时间、术中出血量及术中骨植量比较，差异均无统计学意义（P〉0.05），两组术后均未出现诸如椎管内血肿、截瘫平面上升等较为严重的祌经功能损伤并发症。末次随访（术后2年）与对照组比较，观察组Cobb角明显减小（P0.05），末次随访时两组Frankel分级差异有统计学意义（P［关键词］椎体加椎间植骨融合；胸腰椎爆裂性骨折；后外侧植骨融合［中图分类号］R683［文献标识码］A［文章编号］1673-7210(2016)08(a)-0048-04［Abstract］ObjectiveT

3、oexploretheclinicaleffectofvertebralbodyandintervertebralbonegraftfusioninthetreatmentofthoracolumbarburstfracture.Methods90casesofpatientswiththoracolumbarburstfracturetreatedinthePeople’sHospitalofChinaThreeGorgesUniversityfromApril2012toFebruary2013wereselected.Accordingtotherandomn

4、umbertable，theyweredividedintotheobservationgroupandthecontrolgroup，45casesineachgroup.Allthepatientsweretreatedbyone-stageposteriorshortsegmentinternalfixationandbonegraftfusion.Onthebasisofthetreatment，thecontrolgroupwasreceivedposterolateralbonegraftfusiontreatment.Theobservationgro

5、upwasreceivedthevertebralbodyandintervertebralbonegraftfusiontreatment.Thesurgeryindexesincludingoperationtime,intraoperativebloodlosswereobserved.Allpatientswerefollowed-upfor2years，changeofvertebralCobbangleofthetwogroupswereobserved.TheAnjarwallamethodwasusedtoevaluatetheosseousfusi

6、onsituationinthelastfollow-up.TheFrankelclassificationwasappliedtoassessthepostoperativeneurologicrecovery.ResultsNosignificantdifferenceswereobservedbetweenthetwogroupsintheoperationtime，intraoperativebloodlossandamountofbonegraft(P〉0.05).Inaddition,noneofthemappearedseverepostoperati

7、vecomplicationsofnervefunctioninjury，suchasspinalcanalhematoma，paraplegiaplanerise.Atthelastfollow-up(2yearsaftertreatment)，comparedwiththecontrolgroup，theCobbangleoftheobservationgroupwasobviouslydecreased(P0.05),atthetimeoflastfollow-up,therewassignificantdifferenceinFrankelclassif