摘要
目的探讨后路全内镜手术治疗骨质疏松性椎体压缩骨折的短期疗效与预后情况。方法骨质疏松性椎体压缩骨折病人164例,根据随机信封抽签原则将164例病人分为观察组与对照组,每组各82例。对照组给予传统后路钉棒系统复位内固定术治疗;观察组给予后路全内镜经皮椎体后凸成形术治疗,分析两组短期疗效与预后情况。结果观察组疼痛缓解时间与住院时间分别为(1.36±1.11)天和(7.63±1.87)天,对照组分别为(6.38±1.03)天和(16.22±2.11)天(P<0.05)。观察组与对照组术后4周的脊柱后凸Cobb角低于术前,而伤椎前缘高度与正常高度比值高于术前,组内对比差异有统计学意义(P<0.05),观察组与对照组术后4周的脊柱后凸Cobb角、伤椎前缘高度与正常高度比值与对照组比较,差异有统计学意义(P<0.05)。观察组术后1年神经功能Frankel分级A级、B级、C级、D级、E级,分别有0例、0例、2例、10例和70例,而对照组分别为0例、0例、11例、19例与52例,组间对比差异有统计学意义(P<0.05)。结论后路全内镜手术治疗骨质疏松性椎体压缩骨折短期能较快缓解疼痛,促进康复,改善脊柱功能,在远期神经功能的恢复更好。
Objective To investigate and evaluate the short term and prognosis of posterior total endoscopic percutaneous kyphoplasty in treatment of osteoporotic vertebral compression fracture. Methods 164 patients of osteoporotic vertebral compression fracture were selected and divided into observation group and control group with 82 cases in each group according to the random draw envelope principle, the control group was treated with traditional posterior pedicle screw internal fixation treatment, the observation group was given posterior total endoscopic percutaneous kyphoplasty, the short term and long term progno- sis of two groups were recorded. Results The pain relief time and hospitalization time in the observation group were （ 1.36 ±1.11 ） d and （ 7.63 ±1.87 ） d, respectively, which were significantly less than that of the control group of（ 6.38 ±1.03 ） d and （ 16.22 ±2.11 ） d （ P 〈 0. 05 ）. The postoperative 4 weeks of ky- phosis Cobb angle in the observation group and the control group were significantly lower than that before operation, and the anterior vertebrai height and normal height ratio were significantly higher than that he- fore operation that intra group compared were significantly difference（P 〈 0.05 ） ,while the comparison a- mong groups were significantly difference （P 〈 0.05）. The postoperative 1 year of nerve function Frankel grade in the observation group were 0 case of grade A,0 case of grade B,2 cases of grade C,10 cases of grade D and 70 cases of grade E, and the control group were 0 case,0 case, 11 cases, 19 cases and 52 ca- ses that compared between the two group were significantly difference （P 〈 0.05）. Conclusion Endosco- py percutaneous kyphoplasty;osteoporosis in the treatment of osteoporotic vertebral compression fractures can relieve pain, it promote recovery of spinal function in the short term effects, and it can improve recov- ery of neural function, it is worthy of popularization and application.
作者
李安军
卜志勇
杨祖清
LI Anjun;BU Zhiyong;YANG Zuqing(Department of Spinal Surgery,Renmin Hospital,Hubei University of Medicine,Shiyan 442000,China)
出处
《临床外科杂志》
2018年第8期582-585,共4页
Journal of Clinical Surgery
基金
2016年十堰市科学技术研究与开发项目(16Y45)
关键词
内镜
经皮椎体后凸成形术
骨质疏松
椎体压缩骨折
神经功能
endoscopy
percutaneous kyphoplasty
osteoporosis
vertebral compressionfractures
neural function
