摘要
目的观察手法复位结合单侧穿刺球囊扩张经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的疗效。方法 2005年5月-2009年5月,采用手法复位结合单侧穿刺球囊扩张PKP治疗OVCF42例(A组),并与同期43例单纯行单侧穿刺球囊扩张PKP治疗的OVCF患者(B组)比较术前及术后3d、6个月的疼痛视觉模拟评分(VAS)、椎体高度及后凸角度。A组男6例,女36例;年龄59～93岁,平均76.5岁。骨折涉及胸椎27个节段,腰椎31个节段。根据Zoarski和Peh骨折压缩程度分级法,轻度15个节段,中度38个节段,重度5个节段。骨折至入院时间3h～21d,平均7d。B组男9例,女34例;年龄54～82岁,平均75.3岁。骨折涉及胸椎26个节段,腰椎35个节段。根据Zoarski和Peh骨折压缩程度分级法,轻度21个节段,中度36个节段,重度4个节段。骨折至入院时间1h～20d,平均7d。两组患者一般资料比较,差异均无统计学意义(P>0.05),具有可比性。结果两组手术时间、失血量、每个椎体骨水泥注射量比较,差异均无统计学意义(P>0.05)。两组均无严重并发症及死亡发生。A、B组分别有4例(9.5%)和5例(11.6%)发生骨水泥泄漏。两组术后VAS评分均较术前降低(P<0.01);术后3d和6个月时A组VAS评分与B组比较,差异均有统计学意义(P<0.05)。两组术后椎体压缩率均较术前降低(P<0.01);A组术后3d、6个月椎体压缩率及术后3d椎体高度恢复率均优于B组(P<0.05)。两组术后后凸角度均较术前明显减小(P<0.01);A组术后3d、6个月后凸角度及术后3d恢复率均优于B组(P<0.05)。结论手法复位结合单侧穿刺球囊扩张PKP治疗OVCF疗效优于单纯PKP,对单纯PKP无法治疗的重度OVCF效果较好。
Objective To investigate the efficiency of manual reduction combined with uni-lateral percutaneous kyphoplasty （PKP） in treating osteoporotic vertebral compression fracture （OVCF）. Methods Between May 2005 and May 2009, the manual reduction combined with uni-lateral PKP was applied to treat 42 patients with OVCF （group A）, and the simple uni-lateral PKP was applied to treat 43 patients with OVCF （group B） at the same period. The visual analogue scale （VAS）, the vertebral height, and the Cobb angle were determined before operation, and at 3 days and 6 months after operation. In group A, there were 6 males and 36 females aged 59-93 years （76.5 years on average） with an average disease duration of 7 days （range, 3 hours to 21 days）; 27 segments of thoracic vertebrae and 31 segments of lumbar vertebrae were involved, including 15 segments at mild degree, 38 segments at moderate degree, and 5 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. In group B, there were 9 males and 34 females aged 54-82 years （75.3 years on average） with an average disease duration of 7 days （range, 1 hour to 20 days）; 26 segments of thoracic vertebrae and 35 segments of lumbar vertebrae were involved, including 21 segments at mild degree, 36 segments at moderate degree, and 4 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. There were no significant difference （P〈0.05） in sex, age, affected site, degree, and disease duration between 2 groups. Results There was no significant difference （P〈0.05） in operative time, blood loss, or injected cement volume between 2 groups. No serious complication or death occurred in 2 groups. Cement leakage was observed in 4 cases （9.5%） of group A and in 5 cases （11.6%） of group B. The VAS scores after operation significantly decreased in 2 groups （P〈0.01）. At 3 days and 6 months after operation,the VAS scores in group A we
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第9期1092-1096,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
2005-2006年度成都市卫生局重大科技攻关课题(05004)~~
关键词
骨质疏松
椎体压缩性骨折
手法复位
单侧穿刺
经皮椎体后凸成形术
Osteoporosis Vertebral compression fracture Manual reduction Uni-lateral puncture Percutaneous kyphoplasty
