中国医学前沿杂志（电子版）
中國醫學前沿雜誌（電子版）
중국의학전연잡지（전자판）
CHINESE JOURNAL OF THE FRONTIERS OF MEDICAL SCIENCE(ELECTRONIC VERSION)
2015年
4期
83-86
,共4页
胸腰椎爆裂性骨折%后路植骨融合%椎体加椎间植骨融合%后外侧植骨融合
胸腰椎爆裂性骨摺%後路植骨融閤%椎體加椎間植骨融閤%後外側植骨融閤
흉요추폭렬성골절%후로식골융합%추체가추간식골융합%후외측식골융합
Thoracolumbar burst fracture%Posterior interbody fusion%Vertebral interbody fusion%Posterolateral bone fusion
目的：探讨椎体加椎间植骨融合治疗胸腰椎爆裂性骨折的临床效果。方法按患者就诊顺序将80例胸腰椎爆裂性骨折患者分为对照组和观察组，每组各40例。两组患者均行一期后路开放复位短节段内固定，观察组患者辅以椎体加椎间植骨融合治疗，对照组患者辅以后外侧植骨融合治疗，术后均随访2年，比较两组患者术前、术后即刻及末次随访时伤椎Cobb角及末次随访时矫正度丢失情况、术前及术后Frankel分级情况、术中植骨量及末次随访时骨性融合率。结果两组患者术前、术后即刻伤椎Cobb角比较差异均无显著性（P＞0.05），但本组术后即刻伤椎Cobb角与术前比较差异具有显著性（P＜0.05）。末次随访时两组患者伤椎Cobb角与本组术前及组间比较差异均具有显著性，且两组间矫正度丢失比较差异具有显著性（P＜0.05）。术后两组患者脊髓神经功能较术前均有不同程度改善，且观察组优于对照组。两组患者术中植骨量比较差异无显著性（P＞0.05），但末次随访时两组间骨性融合率比较差异具有显著性（P＜0.05）。结论椎体加椎间植骨融合可获得较好的阶段性骨性融合，是一种理想的植骨融合方式，可加以推广应用；后外侧植骨内固定骨性融合率低，且不符合人体生物力学特点，临床不宜采用。
目的：探討椎體加椎間植骨融閤治療胸腰椎爆裂性骨摺的臨床效果。方法按患者就診順序將80例胸腰椎爆裂性骨摺患者分為對照組和觀察組，每組各40例。兩組患者均行一期後路開放複位短節段內固定，觀察組患者輔以椎體加椎間植骨融閤治療，對照組患者輔以後外側植骨融閤治療，術後均隨訪2年，比較兩組患者術前、術後即刻及末次隨訪時傷椎Cobb角及末次隨訪時矯正度丟失情況、術前及術後Frankel分級情況、術中植骨量及末次隨訪時骨性融閤率。結果兩組患者術前、術後即刻傷椎Cobb角比較差異均無顯著性（P＞0.05），但本組術後即刻傷椎Cobb角與術前比較差異具有顯著性（P＜0.05）。末次隨訪時兩組患者傷椎Cobb角與本組術前及組間比較差異均具有顯著性，且兩組間矯正度丟失比較差異具有顯著性（P＜0.05）。術後兩組患者脊髓神經功能較術前均有不同程度改善，且觀察組優于對照組。兩組患者術中植骨量比較差異無顯著性（P＞0.05），但末次隨訪時兩組間骨性融閤率比較差異具有顯著性（P＜0.05）。結論椎體加椎間植骨融閤可穫得較好的階段性骨性融閤，是一種理想的植骨融閤方式，可加以推廣應用；後外側植骨內固定骨性融閤率低，且不符閤人體生物力學特點，臨床不宜採用。
목적：탐토추체가추간식골융합치료흉요추폭렬성골절적림상효과。방법안환자취진순서장80례흉요추폭렬성골절환자분위대조조화관찰조，매조각40례。량조환자균행일기후로개방복위단절단내고정，관찰조환자보이추체가추간식골융합치료，대조조환자보이후외측식골융합치료，술후균수방2년，비교량조환자술전、술후즉각급말차수방시상추Cobb각급말차수방시교정도주실정황、술전급술후Frankel분급정황、술중식골량급말차수방시골성융합솔。결과량조환자술전、술후즉각상추Cobb각비교차이균무현저성（P＞0.05），단본조술후즉각상추Cobb각여술전비교차이구유현저성（P＜0.05）。말차수방시량조환자상추Cobb각여본조술전급조간비교차이균구유현저성，차량조간교정도주실비교차이구유현저성（P＜0.05）。술후량조환자척수신경공능교술전균유불동정도개선，차관찰조우우대조조。량조환자술중식골량비교차이무현저성（P＞0.05），단말차수방시량조간골성융합솔비교차이구유현저성（P＜0.05）。결론추체가추간식골융합가획득교호적계단성골성융합，시일충이상적식골융합방식，가가이추엄응용；후외측식골내고정골성융합솔저，차불부합인체생물역학특점，림상불의채용。
Objective To explore the clinical effect of vertebral interbody fusion for the treatment of thoracolumbar burst fracture. Method According to the sequence number of 80 cases of patients with thoracolumbar burst fracture were divided into control group and observation group, 40 cases in each group. The two groups underwent one stage posterior open reduction and short segment ifxation, the observation group with vertebral interbody fusion, control group with posterolateral bone fusion, all patients were followed up for two years, patients were compared between the two groups before and after the operation, and at the last follow-up vertebral Cobb angle and the last follow-up correction loss, preoperative and postoperative Frankel grade, grafting bone and at last follow-up, the degree of the bone fusion. Result There was no signiifcant difference between the two groups in preoperative Cobb angle, immediate postoperative Cobb angle (P > 0.05), but Cobbe angle of immediate postoperative in this group was signiifcantly different with peroprative (P<0.05). At last follow-up before the two groups of patients in this group of patients with Cobb angle difference between the two groups and were signiifcant, and the loss of correction between the two groups was signiifcant difference (P<0.05). The two groups of patients before surgery compared with the preoperative neurological function improved in varying degrees, and observation group was better than control group. Two groups of patients undergoing bone volume difference was not statistically signiifcant (P > 0.05). However, at the last follow-up the rate of bone fusion between the two groups was signiifcant difference (P<0.05). Conclusion Vertebral interbody intervertebral fusion can obtain good stage bony fusion, and is an ideal bone grafting, can be extended and applied;posterolateral bone fusion has a lower bone fusion, and does not accord with human body biomechanical characteristics, clinical should not be used.
