Calcium sulfate bone substitute combined with pedicle screw fixation for the recovery of vertebral height following thoracolumbar vertebral compression fractures

doi:10.3969/j.issn.2095-4344.2015.25.008

Abstract

Abstract:

BACKGROUND: Calcium sulfate bone substitute material has a good safety and biocompatibility, and possesses good strength after implantation to restore thoracolumbar mechanical strength and reduce vertebral height loss, and moreover, it may gradually be degraded and absorbed.
OBJECTIVE: To explore the influence of posterior pedicle screw fixation combined with calcium sulfate bone substitute material on the recovery of vertebral height after thoracolumbar vertebral compression fractures.
METHODS: Forty-two patients with thoracolumbar vertebral compression fractures (T12-L3) were enrolled to receive posterior pedicle screw fixation combined with calcium sulfate bone substitute, including 27 males and 15 females, aged 21-57 years. All patients were followed-up for 12 months, and then anterior vertebral height, kyphosis Cobb angle, Oswestry disability index score and visual analog scale score before and after treatment were determined and compared.
RESULTS AND CONCLUSION: At the end of follow-up, no local complications, no coagulation, no immune response and no screw breakage occurred; the anterior vertebral height, kyphosis Cobb angle, Oswestry disability index score and visual analog scale score were significantly improved (P < 0.05). These findings indicate that the posterior pedicle screw fixation combined with calcium sulfate bone substitute can restore the vertebral height and promote functional recovery of patients with thoracolumbar vertebral compression fractures.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Calcium Sulfate, Fractures, Compression, Pain Measurement

CLC Number:

R318

Feng Jie-rong, Du Qing-jun. Calcium sulfate bone substitute combined with pedicle screw fixation for the recovery of vertebral height following thoracolumbar vertebral compression fractures [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(25): 3972-3976.

Figures/Tables 2

References

[1] 赵祥,何升华,丁浩,等.后路经椎弓根硫酸钙骨替代材料椎体内填充治疗胸腰椎压缩骨折[J].中华解剖与临床杂志,2014,19(3): 220-223.

[2] 玄文虎,王红伟,王素伟,等.固态人工颗粒骨在胸腰椎骨折治疗中的临床应用[J].现代医院,2010,10(3):23-25.

[3] 张绍东,吴小涛,杨惠林等.椎弓根钉固定结合注射性硫酸钙椎体成形术治疗胸腰椎骨折[J].中华创伤骨科杂志,2007,9(3): 225-228.

[4] 魏力今,周业金,刘艺明,等.椎弓根钉复位固定结合注射型硫酸钙椎体成形术治疗胸腰椎骨折[J].安徽医科大学学报,2011,46(9): 957-960.

[5] 王洪伟,阮美树,乔巨峰,等.短节段椎弓根钉内固定结合硫酸钙人工颗粒骨椎体成形术治疗新鲜胸腰椎骨折[J].中国骨与关节损伤杂志,2008,23(4):277-279.

[6] 王人彦,王国平,汤志刚,等.硫酸钙人工骨灌注椎体成形结合椎弓根钉固定治疗胸腰椎骨折[J].中医正骨,2007,19(3):11-13.

[7] 高生,李慧章,席平昌,等.硫酸钙椎体成形术联合椎弓根钉内固定治疗创伤性胸腰椎骨折的前瞻性研究[J].中国骨与关节损伤杂志,2012,27(7):586-588.

[8] 王生介,谭红略,赵金坤,等.后路椎弓根钉固定结合硫酸钙骨水泥椎体成形术治疗新鲜胸腰椎压缩性骨折[J].颈腰痛杂志,2010, 31(3):201-204.

[9] 李慧章,高生,席平昌,等.椎弓根螺钉固定结合硫酸钙椎体成形术治疗创伤性胸腰椎骨折[J].中国临床医学,2012,19(4):381-382.

[10] 恽常军,刘锦波,王生介,等.椎弓根钉内固定结合注射型硫酸钙椎体成形术治疗胸腰椎骨折[J].中国基层医药,2011,18(10): 1352-1354.

[11] 黄志海,徐跃根,卢厚微,等.后路复位固定结合硫酸钙椎体成形术治疗胸腰椎骨折[J].浙江医学,2010,32(4):552-553.

[12] 张友,冯世龙,熊小江,等.椎弓根螺钉内固定结合自固化硫酸钙灌注治疗胸腰椎骨折28例[J].第三军医大学学报,2009,31(10): 987-989.

[13] 苏列,苗全顺,韩勇,等.椎体成形术并椎弓根钉内固定治疗胸腰椎骨折52例[J].世界中西医结合杂志,2013,8(5):495-497.

[14] 李慧章,高生,席平昌,等.硫酸钙椎体成形术结合椎弓根螺钉治疗无神经症状的爆裂性胸腰椎骨折[J].生物骨科材料与临床研究, 2012,9(3):10-13.

[15] 邓建龙,王剑敏,陈晓勇,等.椎弓根钉固定硫酸钙人工骨椎体成形术治疗胸腰椎骨折[J].临床军医杂志,2009,37(6):985-987.

[16] 黄玉楷.经椎弓根固定结合硫酸钙椎体成形术对胸腰椎骨折患者治疗效果分析[J].中国医学创新,2011,8(29):42-44.

[17] 周升新.内固定联合注射硫酸钙椎体成形术治疗胸腰椎骨折临床观察[J].东南大学学报:医学版,2014,33(5):577-580.

[18] 史成富,牛德刚,邹方亮,等.后路椎弓根钉棒系统联合医用注射硫酸钙椎体成形术治疗胸腰椎骨折的疗效[J].中国社区医师:医学专业,2011,13(30):99.

[19] 王人彦,郭志辉,王国平,等.硫酸钙人工骨灌注椎体成形结合椎弓根钉治疗胸腰椎骨折[C].//中华中医药学会骨伤分会第四届第三次学术年会暨国家中医药管理局“十一五”重点专科(专病)建设骨伤协作组经验交流会论文集,2008:82-86.

[20] 史锐,朱振军.短节段椎弓根钉内固定结合硫酸钙人工骨椎体成形术治疗胸腰椎骨折[J].浙江创伤外科,2011,16(2):236-238.

[21] 周维永,黄德宁,叶文胜,等.椎弓根钉棒内固定结合可注射性硫酸钙椎体成形治疗胸腰椎椎体骨折[J].医学信息(下旬刊),2013, 26(15):376.

[22] 席秉勇,邵钦,张琰,等.硫酸钙椎体成形结合短节段椎弓根钉固定治疗胸腰椎骨折[J].中国骨与关节损伤杂志,2012,27(5): 433-434.

[23] 李朝明.椎弓根钉内固定联合硫酸钙骨水泥椎体成形术治疗胸腰椎骨折21例临床分析[J].全科医学临床与教育,2014,12(1): 74-75.

[24] 胡优威,张治国,谭益云,等.注射型硫酸钙椎体成形结合椎弓根内固定治疗胸腰椎骨折椎体后凸畸形的疗效观察[J].医学临床研究,2011,28(8):1592-1594.

[25] 谭家昌,徐鸿育,杨有猛,等.经伤椎置钉椎弓根内固定结合硫酸钙人工骨灌注治疗胸腰椎骨折[J].中国骨与关节损伤杂志,2009, 24(6):525-526.

[26] 胡庆丰,范顺武,潘浩,等.肌间隙入路椎弓根钉固定结合椎体成行术治疗胸腰椎骨折[C].//中华中医药学会骨伤分会第四届第三次学术年会暨国家中医药管理局“十一五”重点专科(专病)建设骨伤协作组经验交流会论文集,2008:48-52.

[27] 徐鸿育,李文恒,杨有猛,等.经伤椎置钉椎弓根内固定结合硫酸钙人工骨灌注治疗胸腰椎骨折[C].//第十八届全国中西医结合骨伤科学术研讨会论文集,2011:121-121.

[28] 何庆华.椎弓根钉内固定联合硫酸钙骨水泥椎体成形术治疗胸腰椎骨折32例临床分析[J].生物骨科材料与临床研究,2014, 11(6):65-67.

[29] Ulmar B,Brunner A,Guhring M,et al.Inter- and intraobserver reliability of the vertebral, local and segmental kyphosis in 120 traumatic lumbar and thoracic burst fractures: evaluation in lateral X-rays and sagittal computed tomographies.Eur Spine J.2010;19(4):558-566.

[30] Ulmar B,Brunner A,Guhring M,et al.Inter- and intraobserver reliability of the vertebral, local and segmental kyphosis in 120 traumatic lumbar and thoracic burst fractures: evaluation in lateral X-rays and sagittal computed tomographies.Eur Spine J.2010;19(4):558-566.

[31] Krause M,Breer S,Mohrmann B,et al.Influence of non-traumatic thoracic and lumbar vertebral fractures on sagittal spine alignment assessed by radiation-free spinometry. Osteoporos Int.2013;24(6):1859-1868.

[32] Gertzbein SD,Khoury D,Bullington A,et al.Thoracic and lumbar fractures associated with skiing and snowboarding injuries according to the AO comprehensive classification.Am J Sports Med.2012;40(8):1750-1754.

[33] Gasbarrini A,Cappuccio M.Complications in minimally invasive percutaneous fixation of thoracic and lumbar spine fractures and tumors.Eur Spine J.2013;22(Suppl.6): S965- S971.

[34] Mancini DJ,Burchard KW,Pekala JS et al.Optimal thoracic and lumbar spine imaging for trauma: are thoracic and lumbar spine reformats always indicated? J Trauma.2010;69(1): 119-121.

[35] 于研,曾至立,李山珠,等.伤椎置钉联合可注射硫酸钙治疗围绝经期胸腰椎骨折的疗效分析[J].中华医学杂志,2013,93(45): 3582-3585.

[36] 江渟,潘政军,魏力今,等.医用硫酸钙MIIG115作为椎体成形术材料治疗胸腰椎骨折的近期疗效[J].生物骨科材料与临床研究, 2007,4(2):15-17.

[37] 黄勇,徐峰,蔡贤华,等.经伤椎硫酸钙液态人工骨强化治疗胸腰椎骨折的临床分析[J].生物骨科材料与临床研究,2013,10(3): 19-23.

[38] 朱晓东,蒋富贵,朱立帆,等.单纯内固定与内固定结合椎体成形术治疗胸腰椎骨折的比较[J].临床骨科杂志,2013,16(3):244-247.

[39] 龚健,杨迪,吴月坚,等.椎弓根螺钉系统结合可注射型硫酸钙植骨治疗创伤性胸腰椎骨折[J].医学信息,2013,26(23):205-206.

[40] 杜国聪,李启中,杨朝华,等.椎弓根螺钉系统结合可注射型硫酸钙植骨治疗创伤性胸腰椎骨折[J].广州医药,2013,44(2):13-15.