摘要
目的回顾性比较不同手术治疗单节段骨质疏松性脊柱骨折的效果,为临床合理术式选择提供依据。方法根据不同术式将2013年1月—2015年6月收治的87例单节段骨质疏松性脊柱骨折患者分为A组50例与B组37例,A组行经椎弓根椎体内植骨加短节段内固定治疗,B组则采取单纯短节段内固定治疗,记录两组手术时间、术中出血量、住院时间、并发症等指标,同时对两组患者术前、术后3 d及随访6个月时疼痛视觉模拟量表(VAS)、Cobb'角、椎体高度丢失进行比较。结果两组平均手术时间、术中出血量及住院时间比较差异无统计学意义(P>0.05)。A组并发症发生率显著低于B组(P<0.05)。两组患者术后3 d和随访6个月VAS评分、Cobb'角和椎体高度丢失率均明显低于术前(P<0.05),随访6个月VAS评分明显低于术后3 d(P<0.05)。A组患者术后3 d、随访6个月VAS评分、Cobb'角和椎体高度丢失率均明显低于B组(P<0.05)。结论相比单纯短节段内固定,经椎弓根椎体内植骨加短节段内固定更能减轻患者疼痛程度,减少椎体高度丢失,显著降低内固定物松动或断裂发生率。
Objective To retrospectively compare effects of different surgeries in treatment of patients with monosegment osteoporotic vertebral fractures in order to provide basis for selecting reasonably surgical methods. Methods According to different surgeries, 87 patients with monosegment osteoporotic vertebral fractures during January 2013 and June 2015 were divided into group A （n=50） and group B （n=37）. Group A was treated with transpedicular intracor-poreal grafting combined with short segment fixation, while group B was treated with short segment fixation alone. In two groups, operative time, intraoperative bleeding volume, hospitalization time and complications were recorded, and visual analogue scales （ VAS） , Cobb＆#39; angles and loss rate of vertebral height were compared before and 3 d after surgery and in 6th month of follow-up meanwhile. Results There were no significant differences in averagely operative time, intraopera-tive bleeding volume and hospitalization time between two groups （P〉0. 05）. Incidence rate of complications in group A was significantly lower than that in group B （P〈0. 05）. In two groups, values of VAS, Cobb＆#39;s angle and loss rate of ver-tebral height 3 d after surgery and in 6th month of follow-up were significantly lower than those before surgery （P〈0. 05）, and VAS value in 6th month of follow-up was significantly lower than that 3 d after surgery （P〈0. 05）. Values of VAS, Cobb＆#39;s angle and loss rate of vertebral height 3 d after surgery and in 6th month of follow-up in group A were significantly lower than those in group B （P〈0. 05）. Conclusion Compared with those by simple short segment fixation, transpe-dicular intracorporeal grafting combined with short segment fixation can much relieve pain degree, decrease loss rate of vertebral height and reduce incidence rate of internal fixator loosening or breakage for patients with monosegment osteopo-rotic vertebral fractures.
出处
《解放军医药杂志》
CAS
2016年第9期82-85,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
骨质疏松
脊柱骨折
椎弓根椎体内植骨
短节段内固定
Osteoporosis
Spinal fractures
Transpedicular intracorporeal grafting
Short segment fixation
