Comparison The Clinical Effects Between Vertebral Bone Graft And Interbody Bone Graft In The Treatment Of Denis Type B Thoracolumbar Vertebral Burst Fractures

Objective:Compare the clinical results of posterior short-segment instrumentation combined with vertebral bone grafting and interbody bone grafting in the treatment of Denis type B thoracolumbar burst fractures, provide certain reference for the treatment of thoracolumbar fractures.Methods:Retrospectively analyzed 40 cases of Denis type B thoracolumbar burst fractures in our hospital terated from 2011.1-2014.12,the injury vertebral body range from T11 to L2,all cases underwent thoracolumbar X-ray, CT and MRI, followed up for more than 1 year, each time evaluated image reasults and the spinal cord function.They were divided into two groups according to the different operation methods : group of vertebral bone grafting and interbody bone grafting, record the data of operation time, blood loss in the two groups and preoperative, postoperative, at the time of the last follow-up Cobb angle and vertebral and superior intervertebral space height, compared and analyzed.Results: All the 40 patients were followed up for an average of 19 months. All patients had good bone fusion, and the incision healed primary. No incision infection or cerebrospinal fluid leakage were obtained. The operation time and blood loss of vertebral bone grafting group was less than interbody bone group, the difference is statistically significant(P < 0.05),the difference of Cobb angle and vertebral and superior intervertebral space height of the two bone graft group between preoperative and after the operation immediately is statistically significant(P < 0.05); the difference of Cobb angle and vertebral and superior intervertebral space height of the two bone grafting group between the end of follow-up and the immediate postoperative is not statistically significant(P > 0.05); the average correction loss of vertebral bone grafting group were higher than those in the intervertebral bone graft group, the difference is statistically significant(P < 0.05).36 cases with nerve injury patients, except 1 case of Grade A in vertebral bone graft group without apparent recovery, all the remaining patients received grade 1-2 recovery.comparing the situation of nerve function recovery at the end of follow-up of each group,the difference is not statistically significant(P > 0.05).Conclusions:Treating the Denis type B thoracolumbar burst fracture with intervertebral disc injury by posterior short segment fixation combined with interbody bone graft is better than vertebral bone graft in maintaining postoperative correction, the therapy is effective, it can reconstruct vertebral height, restore anterior column support, promot the healing of the fracture.Although the operation time is extended, and the blood loss in operation will be increased and has high risk of nerve damage,but the result is firm and stable bone fusion.