Rebuilding injured vertebrae by different kinds of bone graft materials to treat thoracoiumbar burst fractures:an imaging verification of bone healing / 中国组织工程研究

ABSTRACT

BACKGROUND:Intravertebral bone graft to rebuild anterior and middle column structure and to recover vertebral morphology has been re-understood, and a suitable bone graft material can promote bone healing and be conducive to rebuild the long-term stability of the spine. OBJECTIVE:To discuss the differences in clinical efficacy of three kinds of bone graft materials through unilateral pedicle to treat thoracolumbar burst fractures. METHODS:Total y 102 thoracolumbar burst fracture patients were randomized into three groups:autologous bone, autologous bone combined with al ogeneic bone and al ogeneic bone were implanted via the unilateral pedicle, respectively, in the three groups. We measured the percentage of height of the anterior edge of vertebral body and Cobb angle by X-Ray before and after bone grafting, and used CT to observe bone graft healing, and used Mimics to measure the defect area of vertebral body at the last fol ow-up. RESULTS AND CONCLUSION:Al the 102 patients were fol owed-up for 24-36 months. The percentage of height of the anterior edge of vertebral body and Cobb angle of three groups were restored after bone grafting (P<0.05), but there was no difference in the percentage of height of the anterior edge of vertebral body of three groups at different time point after bone grafting. The Cobb angle in the al ogeneic bone group was bigger than that in the autologous bone group and autologous bone combined with al ogeneic bone group at 9, 12 and 24 months after bone grafting (P<0.05). The fracture healing rate of the al ogeneic bone group at different time points was lower than that of the autologous bone group and autologous bone combined with al ogeneic bone group (P<0.05), and the area of bone defect was bigger than that in the autologous bone group and autologous bone combined with al ogeneic bone group (P<0.05). These findings indicate that these three bone graft materials can rebuild the vertebral body via the unilateral pedicle to treat thoracolumbar burst fracture, reduce the loss of vertebral height and Cobb angle, and decrease defect area of the vertebral body. The clinical efficacy of autologous bone combined with al ogeneic bone to heal bone graft and reduce bone defect is similar to autologous bone, both of which are better than al ogeneic bone alone.