体位复位在椎体后凸成形术中的应用效果研究  

Effects of hyperextension position and percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures

作　　者：钱宇锋[1] 薛峰[1] 盛晓文[1] 陈兵乾[1] 

机构地区：[1]江苏省常熟市第一人民医院骨科,江苏常熟215500

出　　处：《颈腰痛杂志》2011年第5期338-341,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨椎体后凸成形术中,球囊撑开复位结合躯体过伸复位对骨质疏松性椎体骨折的治疗效果。方法对51例78椎骨质疏松性椎体压缩性骨折患者采用随机双盲法分为对照组和实验组,对照组予以单球囊双侧椎弓根入路椎体后凸成形术;实验组在术前予以极度后伸位复位后进行单球囊双侧椎弓根入路椎体后凸成形术。收集两组术前和术后的伤椎高度,Cobb角改善程度,骨水泥用量以及渗漏病例,VAS以及ODI评分等数据。结果 PKP手术具有迅速缓解疼痛、改善腰部功能、纠正脊柱畸形的效果,对照组和实验组在各方面无明显差异。实验组有1例出现骨水泥渗漏,在随访过程中有2例出现再塌陷。结论在PKP术前结合使用体位复位并不能明显改善复位效果,反而可能因为过度牵拉而增加骨水泥渗漏、术后再塌陷的风险。Objective To evaluate effects of Hyperextension Position in Percutaneous Kyphoplasty（PKP）for osteoporotic vertebral compression fracture.Methods 51 cases（78 vertebral bodies）were divided randomize into control group or experimental group.The control group was performed PKP,and the experimental group was performed Hyperextension Position before PKP.The surgical outcomes were evaluated by visual analogue scale（VAS）and Oswestry disability index（ODI）systems,vertebral height rate restoration,Cobb＇s angles,complications etc.Results All oerations were completed smoothly.No neurologic symptoms appeared postoperatively and the back pain relieved greatly in 72 hours.X-ray examinations revealed that the vertebral were restored and the kyphosis wre corrected obviously.But it was no obvious differences between the two groups.In experimental group,there was one case with asymptomatic cement leakage and two cases with asymptomatic recompression.Conclusion The hyperextension position before PKP couldn＇t make an improvemet,but may increase the risk of cement leakage and recompression for excessive hyperextenion.

关 键 词：体位复位 经皮椎体后凸成形术 骨水泥渗漏 椎体高度 再塌陷 

分 类 号：R589[医药卫生—内分泌]