Bone graft fusion combined with internal fixation restores vertebral height after thoracolumbar fracture and dislocation

doi:10.3969/j.issn.2095-4344.2013.31.024

Abstract

Abstract:

BACKGROUND: Spinal canal decompression and fusion combined with pedicle screw fixation has become the main method for the treatment of thoracolumbar fracture and dislocation.
OBJECTIVE: To restore the vertebral height of the patients with thoracolumbar fracture and dislocation who underwent subtotal resection and decompression through titanium cage packed with autologous cancellous bone and pedicle screw fixation.
METHODS: Thirty-one patients with thoracolumbar fracture and dislocation treated in the Shanghai 6th People’ s Hospital of Shanghai Jiao Tong University from February 2007 to September 2011 were selected. All the patients received subtotal resection, spinal canal decompression and titanium cage packed with autologous cancellous bone and pedicle screw fixation. Imaging examination was performed before and after treatment to observe the recovery of vertebral sequence, vertebral height and Cobb angle, as well as the recovery of nerve function.
RESUTLS AND CONCLUSION: The patients were followed-up for 12 months, and all the patients healed well after treated with titanium cage packed with autologous cancellous bone and pedicle screw fixation, and there was no loosening, shedding or breakage after pedicle screw fixation. During reexamination, the grafts fusion, good deformity correction, basic recovery of vertebral height and good recovery of Cobb angle were observed. Seven cases had neurological function recovery, and among them, six cases raised for one degree, one case raised for two degrees, and another 22 cases without recovery. Case analysis and relative researches showed that subtotal resection and decompression and titanium cage packed with autologous cancellous bone and pedicle screw fixation can reduce the loss of correction of the patients with thoracolumbar fracture and dislocation, restore the vertebral height, and enhance the stability of the vertebral body.

Key words: organ transplantation, organ transplantation academic discussion, bone graft, vertebral height, thoracolumbar fractures, fusion, neurologic function

CLC Number:

R318

Peng Jun, Xu Jian-guang. Bone graft fusion combined with internal fixation restores vertebral height after thoracolumbar fracture and dislocation[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.31.024.

Figures/Tables 6

2 与相关研究结果的比较 2.1 相关研究资料的获取采用检索CNKI数据库的方法获取[1]。 2.2 资料检索方式检索时间范围2003至2012年，检索词为“胸椎骨折；腰椎骨折；植骨融合；内固定；椎体高度；椎体稳定性”，共检索相关文献81篇，学术期刊数据库文献65篇，硕士学位论文数据库文献6篇，中国会议论文数据库文献8篇，国际会议论文数据库文献2篇。最终纳入分析的文献共13篇[2-14]。入选标准：①检索结果中，文献研究内容与椎体减压植骨融合椎弓根钉系统内固定治疗胸腰椎严重骨折脱位有关，并与恢复椎体的高度和稳定性有关，排除与研究目的不相关的文献以及护理内容的文献。②检索文献体例为论著和病例报告等，均为一次性文献，综述为前人的经验和目前研究进展的文献，排除综述类文献。③同一作者的相似和重复研究，只选取其中1篇纳入分析。④纳入自体骨植骨结合椎弓根钉置入内固定治疗胸腰椎严重骨折后椎体高度的研究文献。⑤纳入不同植骨方法恢复胸腰椎严重骨折椎体高度比较的研究文献。⑥纳入经伤椎植骨融合内固定治疗胸腰椎严重骨折后的椎体高度及稳定性研究的文献。⑦纳入经伤椎植骨融合内固定治疗胸腰椎严重骨折后椎体高度和稳定性的影响因素分析的文献。 2.3 自体骨植骨结合椎弓根钉置入内固定治疗胸腰椎严重骨折后椎体高度的恢复谷效斌等[2]研究47例胸腰椎严重骨折患者经自体骨植骨结合椎弓根钉置入内固定治疗后随访12个月时的椎体高度，测量治疗前后的美国脊髓损伤协会分级和目测类比评分，椎体前后缘压缩率、Cobb角和Oswestry功能障碍指数分值，治疗前后椎体前后缘压缩率和Cobb角变化，见表1。"

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