CAJ | 학술논문

目的：观察经椎间孔椎体间植骨与单纯后外侧植骨治疗胸腰段脊柱骨折脱位的效果。方法回顾分析该院2010年12月—2013年6月收治的胸腰段脊柱骨折脱位患者33例为研究对象，根据植骨方式分为经椎间孔椎体间植骨(TLIF 组)和单纯后外侧植骨组(PLF 组)，治疗结束后对比手术时间、出血量、病死率、脊柱融合率、并发症发生率、神经功能恢复情况、Cobb 角恢复情况和椎体高度恢复情况，评价两种植骨方式的优劣。结果TLIF 组手术时间、术中出血量高于 PLF 组(P <0.05)；两组患者的病死率、并发症发生率均为0；随访10~22个月，脊柱骨性融合率 TLIF 组高于 PLF 组(P <0.05)；术后3个月随访神经功能恢复情况组间比较(P>0.05)；椎体高度恢复情况和 Cobb 角恢复情况组间比较(P >0.05)。结论经椎间孔椎体间植骨与单纯后外侧植骨两种植骨方式，前者能够获得更理想的脊柱骨性融合率，但手术时间较长，术中出血量较大。在临床上，如果患者的身体状况允许，最好选择经椎间孔椎体间植骨治疗胸腰段脊柱骨折脱位。
목적：관찰경추간공추체간식골여단순후외측식골치료흉요단척주골절탈위적효과。방법회고분석해원2010년12월—2013년6월수치적흉요단척주골절탈위환자33례위연구대상，근거식골방식분위경추간공추체간식골(TLIF 조)화단순후외측식골조(PLF 조)，치료결속후대비수술시간、출혈량、병사솔、척주융합솔、병발증발생솔、신경공능회복정황、Cobb 각회복정황화추체고도회복정황，평개량충식골방식적우렬。결과TLIF 조수술시간、술중출혈량고우 PLF 조(P <0.05)；량조환자적병사솔、병발증발생솔균위0；수방10~22개월，척주골성융합솔 TLIF 조고우 PLF 조(P <0.05)；술후3개월수방신경공능회복정황조간비교(P>0.05)；추체고도회복정황화 Cobb 각회복정황조간비교(P >0.05)。결론경추간공추체간식골여단순후외측식골량충식골방식，전자능구획득경이상적척주골성융합솔，단수술시간교장，술중출혈량교대。재림상상，여과환자적신체상황윤허，최호선택경추간공추체간식골치료흉요단척주골절탈위。
Objective To study the effect of transforaminal lumbar interbody bone grafting and simple pos-terior bone grafting for the treatment of thoracolumbar spinal fracture and dislocation.Methods Thirty-three cases of chest waist segment spine fracture dislocation admitted from December 2010 June 2013 were analyzed retrospectively.They were divided into transforaminal lumbar interbody bone grafting (TLIF group)and simple posterior bone grafting (PLF group)according to planting bone ways.After treatment, the surgery time,bleeding volume,mortality,spine fusion rate,complications,neural function recovery, cobb angle recovery and vertebral body height recovery were evaluated between two planting bone ways. Results The surgery time and amount of bleeding were higher in TLIF group than that in PLF group (P <0.05),but their mortality and complication rates were all 0.With 10~22 months of follow-up,spinal fu-sion rate of TLIF group was better than PLF group (P <0.05),but there were no statistical defference be-tween the two groups in neurological function recovery after operation and recovery of the vertebral height and cobb angle for 3-months follow-up (P >0.05).Conclusions In clinical practice,if the patient's con-dition is allows,transforaminal lumbar interbody bone grafting may be the best choice for the treatment of thoracolumbar spinal fracture and dislocation.Its shortcoming is the long operation time and larger intra-operative blood loss.