后路内固定辅以植骨融合治疗胸腰椎爆裂性骨折的疗效观察

目的：探讨后路内固定联合植骨融合治疗胸腰椎爆裂性骨折的疗效及对神经功能的影响。方法随机选取我院胸腰椎爆裂性骨折患者85例，按随机数字表法分为两组，所有患者均给予一期后路内固定术，观察组45例辅以椎体加椎间植骨术，对照组40例行后外侧植骨术，比较两组术后伤椎Cobb角、前缘和后缘高度、骨性融合时间和融合率、内固定失效率和神经功能恢复情况。结果两组术后随访时间（24.28±5.12）月。观察组伤椎Cobb角显著低于对照组，伤椎前缘高度和后缘高度均高于对照组，骨性融合时间、融合率、内固定失效率均显著优于对照组（ P＜0.05），术后Frankel分级改善优于对照组（ P＜0.05）。结论一期后路内固定术后辅以椎体加椎间植骨术治疗胸腰椎爆裂性骨折的疗效显著，可使椎体获最佳的骨性融合，患者预后良好。

Effectiveness of centrum combined with interbody bone graft fusion in treatment of thoraco-lumbar burst fractures

Objective To assess the effectiveness of centrum combined with interbody bone graft fusion in treatment of thora -columbar burst fractures and its influence on neurological function .Methods Eighty-five patients of thoracolumbar burst fractures were randomly divided into observation and control groups .All patients in the both groups were treated with the first-stage posterior internal fixation.The control group （ n =40 ） were further treated with bone graft fusion while the observation group （ n =45 ） were further treated with centrum combined with interbody bone graft fusion .The changes of Cobb angle , vertebral height of front edge and vertebral height of the back edge , bone fusion rate , internal fixation failure rate and Frankel grade of fracture vertebral were compared between the two groups after following-up for 2~3 years.Results All 85 patients were followed up for（24.28±5.12）months.The Cobb angle in the observation group was significantly lower while the vertebral height of front edge and vertebral height of back edge were signifi -cantly higher than that in the control group .The bone fusion time , fusion rate and internal fixation failure rate in the observation group were better than that in the control group .All differences were statistically significant （ P〈0.05 ） .The postoperative Frankel grade of the observation group was also better than that of the control group （ P〈0.05 ） .Conclusion The centrum combined with interbody bone graft fusion after the first-stage posterior internal fixation has an obviously effect that can induce optimum bone fusion with good prognosis.