The Curative Effect Observation About Transpedicular Intracorporeal Grafting In Treatment Of Thoracolumbarburst Fracture

Objective：To estimate the clinicle effects of the pedicle bone grafting combinedwith posterior short-segment pedicle srew fixation in the treatment of thoracolumbarblow out fracture.Method：Selecting60patients after the operation treatment about thoracolumbarburst fractures in affiliated hospital of the Yan’an University from February2009toFebruary2011. According the operation method they are divided into two groups, thevertebrae pedicle bone graft combined with30cases of posterior pedicle screw fixation(born graft group) and the list of30cases of Single posterior pedicle screw fixation(internal fixation group). Out according to the patients’ X-rays before and after operation,remove before internal fixation and6months after it removal, measure the change of thevertebral height ratio, the Cobb angle and the injured vertebral wedge angle respectively,between two groups were compared, statistical analysis, eveluate the alinical significanceof two kinds of methods. According to the situation of CT scanning andThree-dimensional reconstruction imaging to judge the healing of the injury vertebralfracture.Results:1.Two groups of patients’ age, sex, fracture type, operation mode, treatment afteroperation and the time of fixation take out, they all have no significant difference.2.According to the X-rays’ observation and measurement, the patients in pediclebone graft group before and after the operation, before the internal fixation removeand6months after it removal, measure the heigh ratio of the vertebral, Cobb angle andthe injured vertebral wedge angle respectively, there was no obvious change. From theCT scanning, finding the bone graft and vertebral bone has healed and did not appeardirected losen, broken nail and broken rods. After statistics analysis, the result has no statistical significance(P>0.05).3.According to the X-rays’ observation and measurement, the patients in simpleposterior internal fixation group after theoperation, before the internal fixation removeand the internal fixation removal after6months measure the heigh ratio of the vertebraland Cobb angle, finding the Cobb angle became bigger, and the vertebral height ratio haslosen. From the CT scanning, some patients’ bone graft of vertebral haven’t achieve bonyunion,2cases of patients with internal fixation bacome losen crowded, after statisticsanalysis, the result was statistically significiant (P<0.05).4.Through the observation of the two groups patients and the comparative analysisabout X-rays and CT scanning of the postoperative, before the internal fixation removeand the internal fixation removal after6months and the change about the healed of thebone graft group fractura, the vertabral height ratio, Cobb angle, vertebral preserve aboutthe height of vertebral injury were all better than simple posterior internal fixation group,after statistics analysis, comparing the two groups has statistical significance(P<0.05).5.After operation treatment, some patients with nervous system injuried hassignificantly improved, all patients were follow-up for doesn’t appear nervous systemsymptoms and damage performance in the late.Conclusion: the vertebrae pedicle bone graft and effectively fill fracture vertebralformed by the reducation of bone defects, increase the strength of the vertebral bone,restore and maintain the height of injured vertebral, make the vertebral bone healing, andrebuilding the sequence and the stability of the spine, compared with the simpe posteriorinternal fixation it can better restore the height of the injury vertebrae anterior and setle,reduce the incidence of internal fixation failure after operation, effectively prevent theinternal fixation after removal about the height of the injured vertabral loss again and thespinal cord injury again.