CAJ | 학술논문

目的：通过38例病例观察椎体内植骨的转归以及椎体内植骨术对胸腰椎骨折复位术后防止矫正度丢失的作用。方法通过术前、术后即刻、术后12个月随访时的侧位X线片，测量伤椎前缘高度比和后缘高度比的变化，分析椎体内植骨在伤椎形态恢复、防止矫正度丢失中的作用；通过术前、术后和随访时的螺旋CT资料，应用Photoshop CS 8.0软件中的“磁性套索”工具对不同时期的植入骨块相对面积和骨缺损相对面积进行测量、比较，观察植入骨块和骨缺损的转归。结果术后12个月时，椎体前、后缘高度比分别降低了0.28%( P＝0.071)和0.17%( P＝0.086)，差异无统计学意义；植入骨块相对面积逐渐缩小，由34.12%降低到13.56%，无新生空腔；骨缺损相对面积逐渐缩小，由18.53%降低到9.29%。结论经椎弓根椎体内植骨可以切实有效地消除伤椎内的空隙，恢复伤椎的结构完整性和初始稳定性；植入的骨粒通过诱导骨愈合，能够维持伤椎的结构完整性和力学稳定性；椎体内的空隙不能完全自愈。
목적：통과38례병례관찰추체내식골적전귀이급추체내식골술대흉요추골절복위술후방지교정도주실적작용。방법통과술전、술후즉각、술후12개월수방시적측위X선편，측량상추전연고도비화후연고도비적변화，분석추체내식골재상추형태회복、방지교정도주실중적작용；통과술전、술후화수방시적라선CT자료，응용Photoshop CS 8.0연건중적“자성투색”공구대불동시기적식입골괴상대면적화골결손상대면적진행측량、비교，관찰식입골괴화골결손적전귀。결과술후12개월시，추체전、후연고도비분별강저료0.28%( P＝0.071)화0.17%( P＝0.086)，차이무통계학의의；식입골괴상대면적축점축소，유34.12%강저도13.56%，무신생공강；골결손상대면적축점축소，유18.53%강저도9.29%。결론경추궁근추체내식골가이절실유효지소제상추내적공극，회복상추적결구완정성화초시은정성；식입적골립통과유도골유합，능구유지상추적결구완정성화역학은정성；추체내적공극불능완전자유。
Objective To observe the prognosis of intracorporeal grafting and its effects in preventing the loss of correction after the reduction of thoracolumbar fractures in 38 cases.Methods The ratios of anterior height and posterior height of the injured vertebral body were measured based on the lateral X-ray iflms preoperatively, immediate after the surgery and at the 12th month after the operation. The effects of intracorporeal grafting were analyzed in promoting the recovery of the morphology of the injured vertebral body and preventing the loss of correction. Based on the spiral computed tomography ( CT ) results preoperatively, postoperatively and in the follow-up, the relative areas of the grafted bone blocks and the bone defects were measured and compared at different times with the Magnetic Lasso tool in the software of Photoshop CS 8.0, and the prognoses of the grafted bone blocks and the bone defects were observed.Results At the 12th month after the operation, the ratios of anterior height and posterior height of the injured vertebral body were decreased by 0.28% (P=0.071 ) and 0.17% (P=0.086 ) respectively, and no statistical differences were found. The relative area of the grafted bone blocks was reduced gradually from 34.12% to 13.56%, without new cavities. The relative area of the bone defects was reduced gradually from 18.53% to 9.29%.Conclusions Transpedicular intracorporeal grafting can effectively eliminate the space and restore the structural integrity and initial stability of the injured vertebral body. The bone healing which is grafted in the vertebral body can maintain the structural integrity and mechanical stability of the injured vertebral body. The bone cavities cannot completely heal naturally .