摘要
目的探讨椎间盘损伤与胸腰段单节段骨质疏松性骨折患者后入路球囊扩张椎体成形术(PKP)后出现后凸畸形的相关性。方法回顾性研究自2012年8月至2015年8月华中科技大学同济医学院附属普爱医院采用PKP治疗的63例胸腰段单节段骨质疏松性骨折患者资料。根据术前有无椎间盘损伤分为观察组(椎间盘有损伤,29例)和对照组(无椎间盘损伤,34例)。通过比较术后1、6、12个月两组患者的伤椎楔变角和矢状位后凸cobb角、同一组患者术后1、6、12个月伤椎楔变角和后凸cobb角、术后1、6、12个月观察组不同Sander分级患者的后凸cobb角,以观察椎间盘损伤与胸腰段单节段骨质疏松性骨折患者后入路PKP后出现后凸畸形的关系。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。所有患者术后获12~30个月(平均19.3个月)随访。观察组患者在术后1、6、12个月的伤椎楔变角(4.9°±2.5°、5.8°±2.4°、6.2°±2.4°)均大于对照组(4.7°±2.4°、5.2°±2.4°、5.8°±2.4°),但差异无统计学意义(P>0.05);观察组患者在术后6、12个月矢状位后凸cobb角(14.4°±3.6°、15.8°±3.5°)均大于对照组(10.1°±3.7°、10.7°±3.8°),差异有统计学意义(P<0.05)。观察组患者在术后6、12个月的后凸cobb角(14.4°±3.6°、15.8°±3.5°)均较术后1个月(10.6°±3.2°)增加,差异有统计学意义(P<0.05);对照组患者在术后1、6、12个月的后凸cobb角有增加趋势,但差异均无统计学意义(P>0.05)。术后1、6、12个月观察组Sander 2、3级患者的后凸cobb角均较Sander 1级患者增加,差异有统计学意义(P<0.05)。结论PKP治疗胸腰段单节段骨质疏松性骨折,患者术后均会出现程度不一的后凸畸形,而椎间盘损伤是加重患者术后后凸畸形的一个重要因素。
Objective To investigate the correlation between intervertebral disc injury and postoperative kyphosis after percutaneous kyphoplasty (PKP) in patients with single-level osteoporotic thoracolumbar fracture. Methods The data of 63 patients were retrospectively analyzed who had been treated at Department of Orthopaedics, Puai Hospital for single-level osteoporotic thoracolumbar fractures from August 2012 to August 2015. They were all treated with posterior balloon dilatation PKP. According to the preoperative MRI data, they were divided into an observation group (29 patients with intervertebral disc injury) and a control group (34 patients without intervertebral disc injury). The wedged angles (WA) and cobb angles of the injured vertebrae were compared between the 2 groups at postoperative 1, 6 and 12 months. The changes in WA and cobb angles were observed in the same group at postoperative 1, 6 and 12 months. The cob angles in the patients with different Sander classifications of intervertebral disc injury in the observation group were observed at postoperative 1, 6 and 12 months. The correlation between intervertebral disc injury and postoperative kyphosis after PKP was statistically analyzed. Results The 2 groups were comparable as there were no significant differences between them in preoperative general data (P>0.05). All the patients were followed up for an average of 19.3 months (from 12 to 30 months). The WAs at postoperative 1, 6 and 12 months in the observation group (4.9°±2.5°, 5.8°±2.4° and 6.2°±2.4°) were insignificantly larger than those in the control group (4.7°±2.4°, 5.2°±2.4° and 5.8°±2.4°)(P>0.05). The cobb angles at postoperative 6 and 12 months in the observation group (14.4°±3.6° and 15.8°±3.5°) were significantly larger than those in the control group (10.1°±3.7° and 10.7°±3.8°)(P<0.05), and also significantly larger than that at postoperative one month in the same group (10.6°±3.2°)(P<0.05). The cobb angles at postoperative1, 6 and 12 months in the control gr
作者
高鑫峰
李鹏
刘明
刘涛
Gao Xinfeng;Li Peng;Liu Ming;Liu Tao(Department of Orthopaedics, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430033, China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第7期591-596,共6页
Chinese Journal of Orthopaedic Trauma
关键词
椎间盘
骨质疏松
椎体成形术
胸腰段骨折
Intervertebral disc
Osteoporosis
Vertebroplasty
Thoracolumbar fractures
