摘要
目的比较手法复位结合弯角经皮椎体成形术(PCVP)与单纯经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果。方法选择2019年1月—2020年1月陕西省榆林市第一医院脊柱外科收治的新鲜单节段OVCF患者97例,根据治疗方式不同分为观察组和对照组,观察组47例采用手法复位结合PCVP治疗,对照组50例采用单纯PKP治疗。记录两组手术使用时间、术中C臂透视次数、治疗相关费用、骨水泥使用量、骨水泥渗漏率、骨水泥在椎体分布情况,比较术前术后伤椎前缘高度(AVH)、后凸Cobb角、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分。结果观察组手术时间、术中C臂透视次数、治疗费用少于对照组,差异有统计学意义(P<0.05)。观察组骨水泥使用的量大于对照组,骨水泥在椎体分布情况优于对照组,差异有统计学意义(P<0.05)。两组骨水泥渗漏率比较,差异无统计学意义(P>0.05)。两组术后AVH、Cobb角、VAS评分、ODI评分与术前比较,差异有统计学意义(P<0.05);两组间AVH、Cobb角、VAS评分、ODI评分比较,差异无统计学意义(P>0.05)。结论手法复位结合PCVP与单纯PKP治疗OVCF均可复位伤椎、改善后凸畸形,但是较PKP节省手术时间、减少术中C臂透视次数、节约治疗费用。
Objective To compare the clinical effects of manual reduction combined with percutaneous curved vertebroplasty(PCVP)and pure percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods A total of 97 fresh single-segment OVCF patients admitted in the Department of Spinal Surgery,the First Hospital Yulin from January 2019 to January 2020 were selected.According to different treatment methods,they were divided into observation group and control group,47 cases in observation group were treated with manual reduction combined with PCVP,and 50 cases in control group were treated with PKP alone.The operative time,intraoperative C-arm fluoroscopy times,treatment related costs,amount of bone cement,bone cement leakage rate,and distribution of bone cement in the vertebral body were recorded between the two groups.Preoperative and postoperative anterior edge height(AVH),cabbose Cobb angle,visual analog scale(VAS)score,and Oswestry dysfunction index(ODI)score were compared.Results The operation time,the number of C-arm fluoroscopy and the cost of treatment of the observation group were less than that of the control group,and the differences were statistically significant(P<0.05).The amount of bone cement in the observation group was greater than that in the control group,and the distribution of bone cement was better than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the leakage rate of bone cement between the two groups(P>0.05).Compared before surgery,there were statistically significant differences in AVH,Cobb angle,VAS score and ODI score between the two groups after surgery(P<0.05);there were no significant differences in AVH,Cobb angle,VAS score and ODI score between the two groups before and after surgery(P>0.05).Conclusion Manipulation reduction combined with PCVP and PKP alone in the treatment of OVCF can reduce the injured vertebrae and improve the kyphosis,but compared with PKP,it can save the op
作者
张宁
蔡飞
李长红
王飞
ZHANG Ning;CAI Fei;LI Changhong;WANG Fei(Department of Spinal Surgery,the First Hospital Yulin(The Second Affiliated Hospital of Yan’an University),Shaanxi Province,Yulin719000,China;Department of Hand and Foot Surgery,the First Hospital Yulin(The Second Affiliated Hospital of Yan’an University),Shaanxi Provinec,Yulin719000,China;Department of Spinal Surgery,Affiliated Hospital of Yan’an University,Shaanxi Province,Yan’an716000,China)
出处
《中国医药导报》
CAS
2021年第21期79-83,共5页
China Medical Herald
基金
陕西省社会发展科技攻关项目(2015SF115)
陕西省延安市科技惠民计划项目(2016HM-10-03)
陕西省延安市科学技术研究发展计划项目(2017KS-06)。
