后路内固定辅以植骨融合治疗胸腰椎爆裂性骨折的疗效观察-论文.pdf

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1、实用医院临床杂志2014年9月第11卷第5期131后路内固定辅以植骨融合治疗胸腰椎爆裂性骨折的疗效观察罗开富，王云海(四川省天全县中医院，四川天全625500)【摘要】目的探讨后路内固定联合植骨融合治疗胸腰椎爆裂性骨折的疗效及对神经功能的影响。方法随机选取我院胸腰椎爆裂性骨折患者85例，按随机数字表法分为两组，所有患者均给予一期后路内固定术，观察组45例辅以椎体加椎间植骨术，对照组4O例行后外侧植骨术，比较两组术后伤椎Cobb角、前缘和后缘高度、骨性融合时间和融合率、内固定失效率和神经功能恢复情况。结果两组术后随访时间(24．28~5．12)月。观察组伤椎Cobb角显著低于对照组，伤椎前缘高

2、度和后缘高度均高于对照组，骨性融合时间、融合率、内固定失效率均显著优于对照组(P<0．05)，术后Franke1分级改善优于对照组(P<0．05)。结论一期后路内固定术后辅以椎体加椎间植骨术治疗胸腰椎爆裂性骨折的疗效显著，可使椎体获最佳的骨性融合，患者预后良好。【关键词】胸腰椎爆裂性骨折；植骨融合；神经功能【中图分类号】R683．2；R687．34【文献标志码】A【文章编号】1672-6170(2014)05-0131-04Efectivenessofcentrumcombinedwithinterbodybonegraftfusionintreatmentofthoraco．1umbarb

3、urstfracturesLKai，ⅣGYun—hai(TianquanHospitalofTraditionalChineseMedi-cine．nquan625500．China)【Abstract】ObjectiveToassesstheefectivenessofcentrumcombinedwithinterbodybonegraftfusionintreatmentofthora—columbarburstfracturesanditsinfluenceonneurologicalfunction．MethodsEighty—fivepatientsofthoracolumbar

4、buntfractureswererandomlydividedintoobservationandcontrolgroups．Allpatientsinthebothgroupsweretreatedwiththefirst—stageposteriorinternalfixation．Thecontrolgroup(n=40)werefurthertreatedwithbonegraftfusionwhiletheobservationgroup(n=45)werefurthertreatedwithcentrumcombinedwithinterbodybonegraftfusion．

5、ThechangesofCobbangle，vertebralheightoffrontedgeandvertebralheightofthebackedge，bonefusionrate，internalfixationfailurerateandFrankelgradeoffracturevertebralwerecomparedbetweenthetwogroupsafterfollowing—upf0r2～3years．ResultsAll85patientswerefollowedupfor(24．28±5．12)months．TheCobbangleintheobservatio

6、ngroupwassignificantlylowerwhilethevertebralheightoffrontedgeandvertebralheightofbackedgeweresignifi—candyhigherthanthatinthecontrolgroup．Thebonefusiontime，fusionrateandinternalfixationfailurerateintheobservationgroupwerebetterthanthatinthecontrolgroup．Alldifferenceswerestatisticallysignificant(P<0

7、．05)．ThepostoperativeFrankelgradeoftheobservationgroupwasalsobetterthanthatofthecontrolgroup(P<0．05)．ConclusionThecentrumcombinedwithinterbodybonegraftfusionafterthefirst·stageposteriorintemalfixationhasano