CAJ | 학술논문

【目的】探讨经伤椎椎弓根植骨内固定非融合技术治疗胸腰段爆裂骨折的临床疗效。【方法】回顾性分析2010年7月至2012年7月保定市第二中心医院胸腰椎爆裂骨折患者198例，所有患者均接受后路短节段内固定手术治疗，未行椎体间融合，其中试验组84例为伤椎单侧置钉加伤椎内植骨，对照组114例伤椎未植入椎弓根钉未行伤椎内植骨，术后随访，比较两组间手术时间、出血量、术后及末次随访时椎体前后缘高度比、后凸cobb角、断钉率、疼痛VAS评分。【结果】两组手术时间及出血量、术后椎体高度及Cobb角比较差异无显著性（ P＜0．05），末次随访时试验组Cobb角和椎体高度、VAS疼痛评分优于对照组。内固定失败均为断钉发生，试验组断钉发生率（3．6％）低于对照组（11．4％），差异具有统计学意义（P ＜0．05）。【结论】经伤椎椎弓根植骨内固定的非融合技术可降低胸腰椎爆裂骨折内固定失败发生率，有助于改善术后远期预后。
【목적】탐토경상추추궁근식골내고정비융합기술치료흉요단폭렬골절적림상료효。【방법】회고성분석2010년7월지2012년7월보정시제이중심의원흉요추폭렬골절환자198례，소유환자균접수후로단절단내고정수술치료，미행추체간융합，기중시험조84례위상추단측치정가상추내식골，대조조114례상추미식입추궁근정미행상추내식골，술후수방，비교량조간수술시간、출혈량、술후급말차수방시추체전후연고도비、후철cobb각、단정솔、동통VAS평분。【결과】량조수술시간급출혈량、술후추체고도급Cobb각비교차이무현저성（ P＜0．05），말차수방시시험조Cobb각화추체고도、VAS동통평분우우대조조。내고정실패균위단정발생，시험조단정발생솔（3．6％）저우대조조（11．4％），차이구유통계학의의（P ＜0．05）。【결론】경상추추궁근식골내고정적비융합기술가강저흉요추폭렬골절내고정실패발생솔，유조우개선술후원기예후。
[Objective] To explore the clinical efficacy of bone graft with internal fixation non-fusion technology via wounded vertebral pedicle for the treatment of thoracolumbar burst fracture .[Methods]Totally 198 patients with thoracolumbar burst fracture in the second central hospital of Baoding city from July 2010 to July 2012 were analyzed retrospectively .All patients underwent posterior short segment internal fixation without interbody fusion .Among them ,the experiment group( n=84) underwent screw fixation in unilateral injured vertebra combined with bone graft in injured vertebra .The control group( n=114) did not underwent pedicle screw fixation and bone graft in injured vertebra .The patients were postoperatively followed up .The operation time ,blood loss ,the ratio of anterior edge height to posterior edge height of vertebra body ,Cobb angle ,screw breakage rate ,VAS pain score after operation and at the last time of follow up were compared between two groups .[Results]There was no significant difference in operation time ,blood loss ,postoperative height of vertebral body and Cobb angle between two groups ( P >0 .05) . Cobb angle ,the height of vertebral body and VAS pain score in experiment group at the last time of follow up were better than those in control group .In this study ,internal fixation failure was caused by broken screw .The incidence of broken screw in experiment group was lower than that in control group ,and there was significant difference ( P<0 .05) .[Conclusion]Bone graft with internal fixation non-fusion technology via injured vertebra can reduce the inci-dence rate of internal fixation failure in thoracolumbar burst fracture ,and is helpful for improving the long-term prog-nosis after surgery .