摘要
目的比较体位复位联合经皮椎体成形术(PVP)治疗不同类型骨质疏松性椎体压缩骨折的临床效果。方法纳入自2016-01—2017-04行体位复位联合PVP治疗的198例骨质疏松性椎体压缩骨折,新鲜骨折组66例(76椎),陈旧性骨折组89例(119椎),Kümmell病组43例(43椎)。结果 Kümmell病组骨水泥注入量大于新鲜骨折组与陈旧性骨折组(P <0.05),而新鲜骨折组与陈旧性骨折组骨水泥注入量差异无统计学意义(P>0.05)。198例均获得随访,随访时间平均9(3~15)个月。3组术后3个月疼痛VAS评分及ODI指数较术前明显降低,差异有统计学意义(P <0.05)。新鲜骨折组与Kümmell病组术后3 d伤椎前缘高度比值较术前明显增加(P <0.05),但陈旧性骨折组手术前后伤椎前缘高度比值差异无统计学意义(P>0.05)。3组术后3 d伤椎Cobb角较术前明显改善,差异有统计学意义(P <0.05)。Kümmell病组后凸矫正率高于新鲜骨折组,新鲜骨折组后凸矫正率高于陈旧性骨折组,差异有统计学意义(P <0.05)。结论针对不同类型骨质疏松性椎体压缩骨折的病理特点,体位复位联合PVP术中进行精准穿刺并注入适量骨水泥均能够取得良好的治疗效果,对于新鲜骨折及陈旧性骨折患者需要预防骨水泥渗漏的发生。
Objective To compare the clinical effects of postural reduction combined with percutaneous vertebroplasty （PVP） in the treatment of different types of osteoporotic vertebral compression fractures. Methods One hundred and ninety-eight cases of osteoporotic vertebral compression fractures treated with the method of postural reduction combined with PVP from January 2016 to April 2017 were studied. There were 66 cases （76 vertebrae） in the fresh fracture group, 89 cases （119 vertebrae） in the old fracture group, and 43 cases （43 vertebrae） in the Kummell disease group. Results The volume of bone cement injected in Kummell disease group was larger than that in fresh fracture group and old fracture group （P 〈0.05）. However, there was no significant difference in the volume of bone cement injected between fresh fracture group and old fracture group （P 〉0.05）. All 198 patients were followed up for an average time of 9 （3-15） months. The VAS score and ODI index 3 months after operation of all 3 groups were significantly lower after operation, differences were significant （P 〈0.05）. The ratio of the height of the anterior margin of the injured vertebra in fresh fracture group and the Kummell disease group was significantly increased on the third day after surgery （P 〈0.05）. However, there was no significant difference in the ratio of the height of the anterior margin of the injured vertebra before and after operation in the old fracture group （P 〉0.05）. The Cobb angle of all 3 groups was significantly improved on the third day after operation, and the difference was significant （P 〈0.05）. The correction rate of kyphosis in Kummell disease group was higher than that in fresh fracture group, and correction rate of kyphosis in fresh fracture group was higher than that in old fracture group, and the difference was significant （P 〈0.05）. Conclusion According to the pathological characteristics of different types of osteoporotic vertebral compression fractures, postur
作者
关平
高建强
成振波
李晓辉
吕泽斌
王志强
GUAN Ping;GAO Jian-qiang;CHEN Zheng-bo;LI Xiao-hui;LV Ze-bin;WANG Zhi-qiang(Department of Orthopedics,People＇s Hospital of Pingliang city,Pingliang,Gansu 744000,China)
出处
《中国骨与关节损伤杂志》
2018年第9期909-912,共4页
Chinese Journal of Bone and Joint Injury
