牵引手法复位椎体成形术治疗骨质疏松性胸腰椎体压缩性骨折  

Vertebroplasty following fracture manipulation under traction for the treatment of osteoporotic thoracolumbar vertebral compression fractures

作　　者：仇建军 纪斌[1] 王明飞[1] 刘铖祎[1] 

机构地区：[1]上海中医药大学附属普陀医院骨科,200062

出　　处：《国际骨科学杂志》2017年第6期389-392,共4页International Journal of Orthopaedics

基　　金：上海市普陀区临床重点专科建设项目(2016PTZK04)

摘　　要：目的探讨牵引手法复位椎体成形术治疗骨质疏松性胸腰椎体压缩性骨折的临床疗效及安全性。方法选取2015年2月至2016年2月我院收治的35例采用牵引手法复位椎体成形术治疗的骨质疏松性胸腰椎体压缩性骨折患者。术前及术后3 d、3个月、6个月、12个月评估患者疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、Cobb角、椎体前缘高度及术后并发症发生情况。结果术后所有患者腰背部疼痛均明显缓解,术前VAS评分为(7.3±1.5)分,术后3 d、3个月、6个月以及12个月VAS评分分别为(3.7±1.2)分、(1.7±0.9)分、(1.7±1.0)分、(1.5±0.9)分;术前Cobb角为27.7°±1.6°,术后3 d、3个月、6个月以及12个月Cobb角分别为19.4°±1.4°、17.6°±1.3°、15.7°±1.1°、15.8°±1.4°;术前椎体前缘高度为(18.0±1.3)mm,术后3 d、3个月、6个月以及12个月椎体前缘高度分别为(24.3±1.6)mm、(25.6±0.8)mm、(26.5±1.0)mm、(26.4±1.1)mm;术前ODI评分为(34.6±1.8)分,术后3 d、3个月、6个月以及12个月ODI评分分别为(20.5±1.7)分、(15.4±1.2)分、(11.8±1.0)分、(11.4±1.4)分。术后3 d、3个月、6个月以及12个月VAS评分、Cobb角、椎体前缘高度、ODI评分均较术前明显改善,差异具有统计学意义(P<0.01)。术后5例患者出现骨水泥渗漏,2例患者出现相邻椎体骨折。结论牵引手法复位椎体成形术治疗骨质疏松性胸腰椎体压缩性骨折可有效缓解疼痛,恢复伤椎解剖结构。Objective To investigate the clinical efficacy and safety of vertebroplasty following fracture manipulation under traction in the treatment of osteoporotic thoracolumbar vertebral compression fractures.Methods From February 2015 to February 2016,35 patients with osteoporotic thoracolumbar vertebral compression fractures were treated by vertebroplasty following fracture manipulation under traction.Visual analog score(VAS),Cobb angle,Oswestry disability index(ODI),vertebral front height and postoperative complications were evaluated before operation,at 3 days,3 months,6 months and 12 months after operation.Results Back pain were relieved in all patients.Preoperatively,VAS score was 7.3±1.5,while it was 3.7±1.2,1.7±0.9,1.7±1.0 and 1.5±0.9 at 3 days,3 months,6 months and 12 months after operation,respectively.Preoperatively,the Cobb angle was 27.7°±1.6°,while it was 19.4°±1.4°,17.6°±1.3°,15.7°±1.1°and5.8°±1.4°at 3 days,3 months,6 months and 12 months after operation,respectively.Preoperatively,vertebral front height was(18.0±1.3)mm,while it was(24.3±1.6)mm,(25.6±0.8)mm,(26.5±1.0)mm and(26.4±1.1)mm at 3 days,3 months,6 months and 12 months after operation,respectively.Preoperatively,the ODI was 34.6±1.8,while it was 20.5±1.7,15.4±1.2,11.8±1.0 and11.4±1.4 at 3 days,3 months,6 months and12 months after operation,respectively.These postoperative measurements mentioned above were improved significantly compared with the preoperative baseline(P<0.01).After operation,5 cases had bone cement leakage and 2 cases suffered adjacent vertebral fractures.Conclusion Vertebroplasty following fracture manipulation under traction can effectively relieve pain and restore the anatomical structure of injured vertebrae in the treatment of osteoporotic thoracolumbar vertebral compression fractures.

关 键 词：牵引手法复位 椎体成形 椎体压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]