rhBMP-2联合后路内固定与椎体内植骨对创伤性A型胸腰椎骨折患者的临床效果研究

目的研究创伤性A型胸腰椎骨折应用重组人骨形态发生蛋白-2(rhBMP-2)联合后路内固定与椎体内植骨治疗的临床效果。方法80例创伤性A型胸腰椎骨折患者,采用随机数字表法分为观察组和对照组,每组40例。对照组患者应用后路内固定与椎体内植骨进行治疗,观察组在对照组基础上应用rhBMP-2进行治疗。对比两组患者术后1周、6个月以及12个月的伤椎前缘高度比与Cobb角;手术相关指标;术后12个月骨折愈合评分以及骨折愈合时间;术后并发症发生情况。结果术后1周、6个月以及12个月,观察组伤椎前缘高度比高于对照组,Cobb角小于对照组,差异具有统计学意义(P<0.05)。两组患者手术时间、住院时间、出血量、引流量对比,差异无统计学意义(P>0.05)。观察组患者术后12个月骨折愈合评分为(9.57±0.85)分,高于对照组患者的(8.42±0.71)分,差异具有统计学意义(P<0.05);观察组术后骨折愈合时间为(7.20±1.01)个月,短于对照组患者的(8.93±1.34)个月,差异具有统计学意义(P<0.05)。观察组患者术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论应用rhBMP-2联合后路内固定与椎体内植骨治疗创伤性A型胸腰椎骨折具有显著效果,能够有效恢复锥体稳定性,患者术后预后更佳,骨折愈合更快,并发症发生率更低,值得推广应用。

Clinical effect of rhBMP-2 combined with posterior internal fixation and vertebral body bone grafting on patients with traumatic type A thoracolumbar fracture

Objective To study the clinical effect of recombinant human bone morphogenetic protein-2(rhBMP-2)combined with posterior internal fixation and vertebral body bone grafting on patients with traumatic type A thoracolumbar fracture.Methods A total of 80 patients with traumatic type A thoracolumbar fracture were divided into observation group and control group by random number table method,with 40 cases in each group.The control group was treated by posterior internal fixation and vertebral body bone grafting,and the observation group was treated by rhBMP-2 on the basis of the control group.The height ratio of the anterior edge of the injured vertebra and Cobb angle 1 week,6 months and 12 months after operation,surgical related indicators,fracture healing score and fracture healing time 12 months after operation,occurrence of complications after operation were compared between the two groups.Results 1 week,6 months and 12 months after operation,the height ratio of the anterior edge of the injured vertebra of the observation group was higher than that of the control group,and Cobb angle was smaller than that of the control group.The difference was statistically significant(P<0.05).There was no statistically significant difference in operation time,hospitalization time,amount of hemorrhage,drainage volume between the two groups(P>0.05).12 months after operation,the fracture healing score of the observation group(9.57±0.85)points was higher than that of the control group(8.42±0.71)points,and the difference was statistically significant(P<0.05).After operation,the fracture healing time of the observation group was(7.20±1.01)months,which was shorter than that of the control group(8.93±1.34)months,and the difference was statistically significant(P<0.05).The incidence of complications after operation of the observation group was obviously lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion RhBMP-2 combined with posterior internal fixation and vertebral bone grafting has a significant effect on traumatic type A thoracolumbar fractures,which can effectively restore the stability of the vertebral body,with a better prognosis,faster fracture healing,and lower incidence of complications.It is worth popularizing and applying.