自体骨联合同种异体骨在胸腰椎爆裂骨折患者单侧椎弓根植入后的应用效果

马启裕; 段筱勇; 郭友忠

doi:10.7619/jcmp.201918020

自体骨联合同种异体骨在胸腰椎爆裂骨折患者单侧椎弓根植入后的应用效果

陕西省镇巴县人民医院骨科, 陕西汉中, 723600

基金项目:

陕西省科学技术研究发展计划项目 S2014UL568210

详细信息

通讯作者:
郭友忠

中图分类号: R683
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出版历程
- 收稿日期: 2019-07-17
- 录用日期: 2019-08-22
- 网络出版日期: 2021-02-28
- 发布日期: 2019-09-27

Application of autologous bone combined with allogeneic bone in unilateral vertebral pedicle arch implantation in patients with thoracolumbar burst fractures

Department of Orthopaedics, Zhenba County People′s Hospital, Hanzhong, Shaanxi, 723600

摘要

摘要:
目的探讨自体骨联合同种异体骨在胸腰椎爆裂骨折患者单侧椎弓根植入后的应用效果。
方法回顾性分析80例胸腰椎爆裂骨折患者的临床资料，根据术中植入材料的不同将其分为联合组(自体骨联合同种异体骨, n=47)与对照组(同种异体骨, n=33), 比较2组的治疗效果。
结果术后, 2组椎体前缘压缩率均较术前显著提高(P < 0.05), 但2组间术后1周及6个月的椎体前缘压缩率均无显著差异(P>0.05); 术后1周, 2组脊椎矢状位Cobb角均较术前显著下降，术后6个月较术后1周小幅上升，组内不同时点差异显著(P < 0.05), 且术后6个月时联合组Cobb角显著小于对照组(P < 0.05); 术后1周, 2组椎管占位率均较术前显著降低，术后6个月椎管占位率小幅上升，组内不同时点差异显著(P < 0.05), 且联合组术后1周及6个月的椎管占位率均显著低于对照组(P < 0.05), 植骨融合率均显著高于对照组(P < 0.05); 术后6个月, 2组神经功能均较术前显著改善(P < 0.05), 且联合组术后6个月的神经功能显著优于对照组(P < 0.05)。
结论自体骨联合同种异体骨在爆裂性胸腰段骨折中具有良好的应用价值，能促进伤椎的恢复。
- 自体骨联合同种异体骨 /
- 同种异体骨 /
- 胸腰椎爆裂 /
- 单侧椎弓跟植入
Abstract:
Objective To study the effect of autologous bone combined with allogeneic bone in unilateral vertebral pedicle arch implantation in patients with thoracolumbar burst fractures.
Methods The clinical data of 80 patients with thoracolumbar burst fractures in the hospital were retrospectively analyzed. The patients were divided into combined group (autologous bone combined with allogeneic bone, n=47) and control group (allogeneic bone, n=33) according to the different intraoperative implantation materials. The treatment effects were compared between the two groups.
Results After surgery, the compression rate of anterior vertebral body was significantly increased, and the difference was significant at different time points (P < 0.05). However, there were no significant differences in the compression rate of anterior vertebral body at 1 week and 6 months after surgery between combined group and control group (P>0.05). At 1 week after surgery, the Cobb angle of spinal sagittal position in the two groups was significantly lower than that before surgery, and was increased modestly at 6 months after surgery compared with that at 1 week after surgery (P < 0.05), and the Cobb angle in combined group was significantly lower than that in control group at 6 months after surgery (P < 0.05). At 1 week after surgery, the spinal canal occupancy rate in the two groups was significantly lower than that in the same group before surgery, and was increased modestly at 6 months after surgery (P < 0.05), and there was a significant between-group difference in spinal canal occupancy rate (P < 0.05). The spinal canal occupancy rate in combined group at 1 week and 6 months after surgery was significantly lower than that in control group (P < 0.05). The fusion rate of bone grafting in combined group was significantly higher than that in control group at 1 week and 6 months after surgery (P < 0.05). At 6 months after surgery, the neurological function in the two groups was significantly improved than before surgery (P < 0.05), and the combined group was significantly higher than the control group at 6 months after surgery (P < 0.05).
Conclusion Autologous bone combined with allogeneic bone has good application value in thoracolumbar burst fractures, and it can promote the recovery of injured vertebrae.
- autologous bone combined with allogeneic bone /
- allogeneic bone /
- thoracolumbar burst /
- unilateral vertebral pedicle arch implantation

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表 1 2组椎体前缘压缩率变化(x±s) %

组别	n	术前	术后1周	术后6个月
对照组	33	52.03±11.57	93.53±2.43^*	91.66±2.46^*
联合组	47	51.47±13.58	93.14±2.15^*	92.42±2.53^*
与术前比较, *P < 0.05。

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表 2 2组脊柱矢状位Cobb角变化(x±s) °

组别	n	术前	术后1周	术后6个月
对照组	33	18.41±3.41	3.83±1.52^*	4.83±1.15^*#
联合组	47	18.32±3.33	3.41±1.36^*	4.13±1.04^*#△
与术前比较, *P < 0.05; 与术后1周比较, #P < 0.05; 与对照组比较, △P < 0.05。

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表 3 2组椎管占位率比较(x±s) %

组别	n	术前	术后1周	术后6个月
对照组	33	36.03±4.23	3.71±0.52^*	4.51±0.63^*#
联合组	47	35.47±4.14	3.46±0.45^*△	4.16±0.57^*#△
与术前比较, *P < 0.05; 与术后1周比较, #P < 0.05; 与对照组比较, △P < 0.05。

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表 4 2组患者神经功能比较[n(%)]

组别	时点	A级	B级	C级	D级	E级
对照组(n=33)	术前	0	4(12.12)	17(51.52)	9(27.27)	3(9.09)
	术后6个月	0	1(3.03)^*	10(30.30)^*	3(9.09)^*	19(57.58)^*
联合组(n=47)	术前	0	7(14.89)	23(48.94)	10(21.28)	7(14.89)
	术后6个月	0	0^*	3(6.38)^*#	8(17.02)^*#	36(76.60)^*#
与术前比较, *P < 0.05; 与对照组比较, #P < 0.05。

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自体骨联合同种异体骨在胸腰椎爆裂骨折患者单侧椎弓根植入后的应用效果

通讯作者: 郭友忠

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出版历程

Application of autologous bone combined with allogeneic bone in unilateral vertebral pedicle arch implantation in patients with thoracolumbar burst fractures

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通讯作者:
郭友忠