| Objective：To observe the thoracic and lumbar fracture of patients that were treated byposterior open reduction and fixation and vertebral body bone graft bone healing outcomesafter treatment and its effect on the stability of the vertebral body; we will analyse of theweight of bone graft and the final follow-up were injured when the residual correlation ofbone defect size vertebra; we will evaluate of curative effect after fracture to providescientific basis for vertebral body bone graft in the treatment of thoracic and lumbarvertebrae.Methods：we select the thoracic and lumbar instability burst fracture in49cases patientsthat preoperative vertebral CT plain scan, which used pedicle screw reduction anddistraction, interbody bone grafting in the treatment of1weeks after operation, and thefinal follow-up were performed vertebral CT examination that were measured beforeoperation from CT to observe the operation and after the end of vertebral compression rateafter1week, compression rate and the trailing edge angle Cobb, and observe thepostoperative non vertebral instability; we will collect the three period of the CTtwo-dimensional Dicom image input Mimics and ANSYS finite element software, thethree-dimensional finite element models are established bone graft and vertebral bonedefect model, we will use the finite element software the fine segmentation techniquemeasure preoperative vertebral volume, the volume of grafted bone, operation the vertebralbody volume after1week, terminal vertebral volume and final transpedicular bone defectfrom residual volume, we will calculate the result after open reduction and injuredvertebrae defect volume the terminal wound, and we will compare the residual volume ofbone defect vertebral, healing rate of the bone graft in the treatment of bone defect after thefinal volume is smaller and the calculation of bone vertebral concluded; we will analysethe bone volume in operation and final injury of the bone defect size residues within thevertebral Relevance to clinical evaluation of Charles standard. Results：The49cases patients were Vertebral follow-up of with terminal after1weektrailing edge compression ratio, Cobb angle, vertebral body respectively:1week afteroperation (5.4±2)%,(2.2±1.3)%,(8.1±3)°,(47.16±7.22) cm3; end at the end offollow-up (5.9±2.4)%,(2.7±1.4)%,(8.4±2.8)°,(46.29±8.01) cm3,1weeks aftersurgery and the final follow-up showed no significant difference (P>0.05), no internalfixation loosening, broken nails, broken rod, recurrence fracture of vertebral resetinstability phenomenon, suggesting that bone graft of vertebral stability is good; after openreduction and injured vertebrae defect volume was (21.47±8.26) cm3, terminaltranspedicular residual bone defect volume (7.94±4.59) cm3, they had significantdifference (P<0.05), suggesting that the injured vertebra after bone grafting for thetreatment of bone defect after the final volume becomes small, healing rate of bonetransplantation:60.1±9.4%; bone volume in operation and the final follow-up injuredbone defect size is positively related to residual vertebral; Charles standard evaluation ofclinical efficacy: the excellent and good rate was92%.Conclusions：The formation of bone defects in the fracture of thoracic and lumbar wasvertebrae screw after open reduction, treatment methods after translaminar in vertebralimplantation of autogenous bone and allogenic bone, the outcome has the followingcharacteristics:1. bone graft can help maintain the vertebral height and shape stability,avoid the kyphotic angulation deformity, vertebral instability of rare occurrence after the.2.bone was able to survive in the bone defect area, healing rate can reach about60%.3. inthe bone graft in the treatment of the same methods, preoperative vertebral compressiondegree more serious defect, fracture distraction form is larger, the implant bone is more,and the final vertebral healing effect is worse.4. postoperative patients with back pain andfunctional limitation of low incidence, it is worthy of clinical application. |
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