摘要
[目的]探讨采用三点复位联合经皮球囊扩张后凸椎体成形术(percutaneous kyphoplasty,PKP)治疗伴椎体后壁破裂胸腰椎骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的安全性和有效性。[方法]回顾性分析2019年1月—2020年10月本科收治的95例OVCF患者的临床资料,依据术前影像,12例伴有椎体后壁破裂,83例无后壁破裂。两组患者均先采用三点复位,再行PKP技术治疗。比较两组围手术期、随访及影像资料。[结果]所有患者均顺利完成手术,均无严重并发症发生。两组手法复位时间、手术时间、透视次数、骨水泥注入量、骨水泥渗漏率、下地活动时间、住院时间的差异均无统计学意义(P>0.05)。所有患者均获随访(15.03±6.77)个月。两组恢复完全负重活动时间的差异无统计学意义(P>0.05)。随时间推移,两组腰痛VAS及ODI评分显著降低(P<0.05),相应时间点,两组之间VAS及ODI评分的差异均无统计学意义(P>0.05)。影像方面,与术前相比,两组术后伤椎椎体前缘高度显著增加(P<0.05),局部Cobb角显著减小(P<0.05)。术前破裂组伤椎椎体前缘高度显著低于未破裂组(P<0.05),但两组伤椎局部Cobb角差异无统计学意义(P>0.05);术后相应时间点,两组伤椎椎体前缘高度、局部Cobb角的差异均无统计学意义(P>0.05)。[结论]三点复位联合PKP技术治疗OVCF安全有效,尤其是伴椎体后壁破裂的OVCF患者,能够恢复椎体高度,缓解疼痛。
[Objective]To investigate the safety and clinical outcomes of three-point reduction combined with percutaneous kyphoplasty(PKP)for thoracolumbar osteoporotic vertebral compression fracture(OVCF)complicated with posterior wall rupture.[Methods]A retrospective study was done on 95 patients who received surgical treatment for OVCF in our hospital from January 2019 to October 2020.Based on preoperative radiographs,12 patients were complicated with the posterior wall rupture(the rupture group),while the remaining 83 patients had no posterior wall rupture(non-rupture group).All the patients in both groups were treated with three-point reduction,followed by PKP.The data regarding to perioperative period,follow-up and images were compared between the two groups.[Results]All the patients in both groups had operation performed smoothly without serious complications.There were no significant differences between the two groups in terms of reduction time,operation time,fluoroscopy times,volume of bone cement injected,bone cement leakage,postoperative walking time and hospital stay(P>0.05).All of them in both groups were followed up for(15.03±6.77)months on an average,without a significant difference between the two groups in the time to resume full weight-bearing activity(P>0.05).The VAS and ODI scores significantly decreased in both groups over time(P<0.05),whereas which proved not statistically significant between the two groups at any matching time points(P>0.05).Radiographically,the anterior vertebral height significantly increased(P<0.05),whereas the local kyphotic Cobb angles significantly decreased in both groups postoperatively compared with those preoperatively(P<0.05).Although the rupture group had significantly lower anterior vertebral height than the non-rupture group preoperatively(P<0.05),there were no statistically significant differences in terms of anterior vertebral height and local kyphotic Cobb’s angle between the two groups postoperatively(P>0.05).[Conclusion]The three-point reduction combined with PKP
作者
张黎文
王凌斌
任忠明
李俊杰
潘俊英
ZHANG Li-wen;WANG Ling-bin;REN Zhong-ming;LI Jun-jie;PAN Jun-ying(Department of Orthopedics,Zhejiang Sian International Hospital,Jiaxing 314000,China;Department of Orthopedics,Ningxia Traditional Chinese Medicine Hospital and Chinese Medicine Research Center,Yinchuan 750021,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第21期1930-1934,共5页
Orthopedic Journal of China
关键词
骨质疏松性骨折
后壁破裂
手法复位
经皮椎体后凸成形术
thoracolumbar osteoporotic vertebral compression fracture
posterior wall rupture
manual reduction
percutaneous kyphoplasty
