摘要
目的:探讨手法复位联合经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效和安全性。方法:回顾性分析80例OVCF患者的病例资料,根据采用的治疗方法分为3组,采用手法复位联合PVP治疗28例、采用手法复位联合经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗25例、采用单纯PKP治疗27例。比较3组患者的手术时间、术中透视次数、骨水泥分布情况、骨水泥渗漏情况、腰背部疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分。结果:3组患者手术时间、术中透视次数、骨水泥分布情况比较,组间差异均有统计学意义(F=4.424,P=0.015;F=5.584,P=0.004;Z=13.759,P=0.001)。手法复位联合PVP组手术时间短于手法复位联合PKP组和单纯PKP组(P=0.008;P=0.019);手法复位联合PKP组和单纯PKP组手术时间的差异无统计学意义(P=0.724)。手法复位联合PVP组术中透视次数少于手法复位联合PKP组和单纯PKP组(P=0.001;P=0.019);手法复位联合PKP组和单纯PKP组术中透视次数的差异无统计学意义(P=0.348)。手法复位联合PKP组的骨水泥分布情况最优,手法复位联合PVP组次之,单纯PKP组最差(R1=33.94;R2=34.39;R3=52.92)。3组患者治疗前、治疗后1周的腰背部疼痛VAS评分比较,组间差异无统计学意义(F=0.186,P=0.830;F=0.988,P=0.376);3组患者治疗后1周的腰背部疼痛VAS评分均显著低于治疗前[(7.5±1.3)分,(2.0±0.5)分,t=20.894,P=0.000;(7.7±1.5)分,(2.0±0.7)分,t=16.613,P=0.000;(7.7±1.4)分,(2.2±0.6)分,t=18.762,P=0.000]。3组患者治疗前、治疗后1周的ODI评分比较,组间差异无统计学意义(F=0.375,P=0.688;F=0.728,P=0.485)。3组患者治疗后1周的ODI评分均显著低于治疗前[(40.2±7.5)分,(20.4±7.4)分,t=9.944,P=0.000;(41.5±7.3)分,(20.1±7.0)分,t=10.579,P=0.000;(41.8±7.0)分,(22.3±7.2)分,t=10.090,
Objective:To explore the clinical curative effects and safety of manipulative reduction combined with percutaneous vertebroplasty(PVP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:The medical records of 80 OVCF patients were analyzed retrospectively.The patients were divided into three groups according to the therapies they received.Twenty-eight patients were treated with manipulative reduction combined with PVP(group A),25 patients were treated with manipulative reduction combined with percutaneous kyphoplasty(PKP)(group B),while the others were treated with monotherapy of PKP(group C).The operative time,intraoperative X-ray exposure,bone cement distribution,bone cement leakage,low back pain visual analogue scale(VAS)scores and Oswestry disability index(ODI)scores were compared between the 3 groups.Results:There was statistical difference in operative time,intraoperative X-ray exposure and bone cement distribution between the 3 groups(F=4.424,P=0.015;F=5.584,P=0.004;Z=13.759,P=0.001).The operative time was shorter in group A compared to group B and group C(P=0.008;P=0.019),and there was no statistical difference between group B and group C(P=0.724).The intraoperative X-ray exposure was less in group A compared to group B and group C(P=0.001;P=0.019),and there was no statistical difference between group B and group C(P=0.348).The bone cement had optimal-toworst distribution in group B,A and C in turn(■=33.94;■=34.39;■=52.92).There was no statistical difference in low back pain VAS scores between the 3 groups before the treatment and at 1 week after the treatment(F=0.186,P=0.830;F=0.988,P=0.376).The low back pain VAS scores decreased significantly at 1 week after the treatment compared to pretreatment in the 3 groups(7.5+/-1.3 vs2.0+/-0.5 points,t=20.894,P=0.000;7.7+/-1.5 vs 2.0+/-0.7 points,t=16.613,P=0.000;7.7+/-1.4 vs 2.2+/-0.6 points,t=18.762,P=0.000).There was no statistical difference in ODI scores between the 3 groups before the treatment and at 1 week after the treatment
作者
李洪珂
郝申申
董胜利
刘帅
陈红磊
张志芳
王鹏程
杨贤玉
郭阿雷
LI Hongke;HAO Shenshen;DONG Shengli;LIU Shuai;CHEN Honglei;ZHANG Zhifang;WANG Pengcheng;YANG Xianyu;GUO Alei(General Hospital of Pingmei Shenma Medical Group,Pinglingshan 467000,Henan,China)
出处
《中医正骨》
2020年第8期6-11,共6页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
脊柱骨折
胸椎
腰椎
骨折
压缩性
骨质疏松性骨折
正骨手法
椎体成形术
椎体后凸成形术
临床试验
spinal fractures
thoracic vertebrae
lumbar vertebrae
fractures,compression
osteoporotic fractures
bone setting manipulation
vertebroplasty
kyphoplasty
clinical trial
