摘要
目的比较两种术式治疗骨质疏松(PDF)性椎体骨折合并神经损害的临床效果。方法以86例PDF性椎体骨折合并神经损害患者为研究对象,依据患者自愿原则分为A组(实施后路全椎板切除减压术治疗,n=41)及B组(实施后路减压椎体成形短节段融合术治疗,n=45),术后3个月,比较两组治疗效果(后凸Cobb角、椎体前缘压缩率)、视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数问卷量表(ODI)评分、神经功能恢复情况(Frankel分级评分)及术后并发症发生率。结果与术前比较,术后两组后凸Cobb角、椎体前缘压缩率、VAS、ODI评分明显降低,B组的改变较A组更显著(P<0.05);术后B组神经功能恢复效果(88.89%)高于A组(70.73%),并发症发生率(4.44%)均低于A组(19.51%)(P<0.05)。结论后路减压椎体成形短节段融合术治疗PDF性椎体骨折合并神经损害患者的疗效好于后路全椎板切除减压术,且术后并发症发生率低,建议临床推广应用。
Objective To compare the effects of two operating methods in the treatment of osteoporosis （PDF） verlebral fraeture complicated with nerve damage. Methods A total of 86 patients with PDF vertebral fracture complicated with nerve damage were selected as study subjects and divided into group A （to receive posterior total laminectomy decompression, n=41） and group B （to receive posterior decompression vertebroplasty combined with short segment tusion, n=45）. Three months after the operation, the effects [kyphotic Cobb angle and anterior margin compression rate], visual analogue scale （VAS） scores, Oswestry disability index （ODI） questionnaire scale scores, recovery of neurological tunction [Frankel grading scores] and incidence of postoperative complications between the two groups were compared. Results The postoperative kyphotic Cobb angle, anterior margin compression rate and VAS and ODI scores in the two groups were significantly lower than those before the operation, and the changes in group B were more significant than those in group A （P 〈 0.05）; the recovery rate of neurological function （88.89%） in group B was better than that （70.73%） in group A, and the incidence of complications （4.44%） was lower than that in group A （19.51%）（P 〈 0.05）. Conclusion Posterior decompression vertebroplasty combined with short segment tusion has better effects and lower incidence of postoperative complications than posterior total laminectomy decompression in the treatment of PDF vertebral fracture complicated with nerve damage and is recommended to be clinically promoted and applied.
作者
陈小光
Chen Xiaoguang(Department of Orthopaedics,Beijing Pinggu Hospital,Beijing,101200,China)
出处
《西南国防医药》
CAS
2018年第8期708-711,共4页
Medical Journal of National Defending Forces in Southwest China
关键词
骨质疏松
椎体骨折
神经损害
减压
椎体成形
短节段融合
椎板切除
疗效
PDF
vertebral fracture
nerve damage
decompression
vertebroplasty
short segment tusion
laminectomy
ettect
