CAJ | 학술논문

目的：探讨Denis B型胸腰椎爆裂骨折的有效治疗方法。方法选取2010年2月至2013年1月我院收治的74例Denis B型胸腰椎爆裂骨折患者，采用随机数表法分为观察组39例和对照组35例，分别植入同种异体骨和硫酸钙。比较两组患者的手术情况、Cobb角、椎体前缘高度压缩率及骨缺损情况，评价术后视觉模拟评分法(VAS)、日本骨协评估治疗分数(JOA)评分及Frankel脊髓损伤分级、Qswestry腰痛功能障碍分级。结果观察组患者的手术时间和术中出血量分别为(145.7±29.4) min和(287.6±100.3) ml，对照组分别为(147.3±30.6) min和(280.5±96.7) ml，两组比较差异均无统计学意义(P>0.05)；两组患者术后的Cobb角改善情况比较差异无统计学意义(P>0.05)，观察组的椎体前缘高度压缩率及骨缺损情况优于对照组，差异具有统计学意义(P<0.05)。观察组术后VAS为(2.3±0.8)分，JOA为(25.8±1.4)分；Frankel C级0例，D级6例，E级33例；Qswestry P0级31例，P1级8例。对照组术后VAS为(2.4±1.1)分，JOA为(26.3±0.9)分；Frankel C级0例，D级5例，E级30例；Qswestry P0级28例， P1级7例。以上各项指标比较差异均无统计学意义(P>0.05)。结论同种异体骨与硫酸钙内植入均能有效治疗Denis B型胸腰椎爆裂骨折，且同种异体骨在改善椎体前缘高度压缩率及骨缺损程度方面更具优势。
목적：탐토Denis B형흉요추폭렬골절적유효치료방법。방법선취2010년2월지2013년1월아원수치적74례Denis B형흉요추폭렬골절환자，채용수궤수표법분위관찰조39례화대조조35례，분별식입동충이체골화류산개。비교량조환자적수술정황、Cobb각、추체전연고도압축솔급골결손정황，평개술후시각모의평분법(VAS)、일본골협평고치료분수(JOA)평분급Frankel척수손상분급、Qswestry요통공능장애분급。결과관찰조환자적수술시간화술중출혈량분별위(145.7±29.4) min화(287.6±100.3) ml，대조조분별위(147.3±30.6) min화(280.5±96.7) ml，량조비교차이균무통계학의의(P>0.05)；량조환자술후적Cobb각개선정황비교차이무통계학의의(P>0.05)，관찰조적추체전연고도압축솔급골결손정황우우대조조，차이구유통계학의의(P<0.05)。관찰조술후VAS위(2.3±0.8)분，JOA위(25.8±1.4)분；Frankel C급0례，D급6례，E급33례；Qswestry P0급31례，P1급8례。대조조술후VAS위(2.4±1.1)분，JOA위(26.3±0.9)분；Frankel C급0례，D급5례，E급30례；Qswestry P0급28례， P1급7례。이상각항지표비교차이균무통계학의의(P>0.05)。결론동충이체골여류산개내식입균능유효치료Denis B형흉요추폭렬골절，차동충이체골재개선추체전연고도압축솔급골결손정도방면경구우세。
Objective To explore effective treatment options for patients with Denis B type thoracolumbar burst fracture. Methods Seventy-four patients of Denis type B thoracolumbar burst fracture in our hospital from Febru-ary 2010 to January 2013 were selected. The patients were divided into observation group (n=39) and control group (n=35) according to a random number table, which were implanted with allograft and calcium sulfate, respectively. Two groups were compared in surgical cases, Cobb angle, vertebral height compression ratio and bone defects. The postopera-tive Visual Analogue Scale (VAS), Japan Association for Assessing Bone Treatment Fraction (JOA) score and Frankel classification of spinal cord injury, Qswestry back pain dysfunction classification were evaluated. Results The opera-tive time and blood loss were (145.7±29.4) min and (287.6±100.3) ml in observation group, and (147.3±30.6) min and (280.5 ± 96.7) ml in the control group, respectively, with no statistically significant difference between the two groups (P>0.05). The improvement of postoperative Cobb angles also showed no statistically significant difference between the two groups (P>0.05). The vertebral compression height and bone defects in the observation group were significant-ly better than those in the control group (P<0.05). Results showed postoperative VAS (2.3±0.8), JOA (25.8±1.4), Fran-kel C grade 0 cases, D grade 6 cases, E grade 33 cases, Qswestry P0 grade 31 cases, P1 grade 8 cases in the observa-tion group, and postoperative VAS (2.4 ± 1.1), JOA (26.3 ± 0.9), Frankel C grade 0 cases, D grade 5 cases, E grade 30 cases, Qswestry P0 grade 28 cases, P1 grade 7 cases in the control group, with no statistically significant difference be-tween the two groups (P>0.05). Conclusion Calcium sulfate and allograft implants can both effectively treat Denis type B thoracolumbar burst fracture, and allograft is advantageous in terms of improving the compression rate of verte-bral height and the extent of bone defects.