两种微创方法治疗中老年骨质疏松性胸腰椎压缩骨折的疗效比较分析  

Two methods of minimally invasive treatment of quinquagenarian of OVCF of the curative effect of comparative analysis

作　　者：李强[1] 钱萍[1] 万仲贤[1] 熊福生[1] 周燕 喻刚[1] 吴威甫 LI Qiang;QIAN Ping;WAN Zhongxian;XIONG Fusheng;ZHOU Yan;YU Gang;WU Weifu(Second Department of Ortho.paedics,Suining Chinese Medicine Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中医院骨二科,四川629000

出　　处：《现代医药卫生》2018年第17期2645-2647,共3页Journal of Modern Medicine & Health

摘　　要：目的比较经皮椎弓根钉内固定、自固化磷酸钙骨水泥(CPC)+经皮椎体后凸成形术(PKP)治疗中老年骨质疏松性胸腰椎压缩骨折(OVCF)的疗效。方法回顾性比较分析来自2013年6月至2016年6月该院诊治的中老年OVCF患者62例作为研究对象。采用经皮椎弓根钉内固定治疗28例(对照组),采用CPC+PKP治疗34例(观察组)。比较2组治疗后1周和1、3、6个月疼痛视觉模拟(VAS)评分、伤椎椎体前后缘高度百分比和伤椎后凸Cobb角。结果 2组均获得随访6~12个月,中位时间为8.6个月,所有患者的骨折均愈合。2组术后VAS评分、Cobb角和伤椎椎体前后缘高度百分比较术前明显改善,差异均有统计学意义(P<0.05)。2组术后1周,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。对照组Cobb角和伤椎椎体前后缘高度百分比改善情况优于观察组,差异均有统计学意义(P<0.05)。术后1、3、6个月,2组VAS评分、Cobb角和伤椎椎体前后缘高度百分比组内比较,差异均无统计学意义(P>0.05);VAS评分组间比较差异无统计学意义(P>0.05);对照组Cobb角和伤椎椎体前后缘高度百分比改善情况优于观察组,差异有统计学意义(P<0.05)。结论 2组术后1周,腰背疼痛均得到明显缓解,椎体形态得到恢复,早期临床疗效确切。相对于对照组,观察组损伤更小,手术时间短,早期缓解疼痛更明显;对照组在恢复椎体形态、维持力学稳定方面更具优势。Objective To compare the efficacy of percutaneous pedicle screw fixation,self-curing calcium phosphate cement(CPC)+percutaneous kyphoplasty(PKP)in the treatment of middle-aged and elderly osteoporotic thoracolumbar verte-bral compression fractures(OVCF).Methods A retrospective comparison of 62 elderly patients with OVCF from June 2013 to June 2016 was performed.Twenty-eight patients(control group)were treated with percutaneous pedicle screw fixation and 34 patients(observation group)were treated with CPC+PKP.One week,1,3,and 6 months after treatment,the pain visual analogue(VAS)score,the percentage of the anterior and posterior border height of the injured vertebral body,and the Cobb angle of the injured kyphosis were compared.Results Both groups were followed up for 6 to 12 months,with a median time of 8.6 months.All patients had fractures that healed.The VAS score,Cobb angle and percentage of anterior and posterior margin of the injured vertebrae were significantly improved in the two groups(P<0.05).The VAS score of observation group was lower than that of the control group 1 week after operation,and the difference was statistically significant(P<0.05).The percentage improvement of the height of the anterior and posterior margins of the Cobb angle and the injured vertebral body in the control group was better than that in the observation group,and the difference was statistically significant(P<0.05).At 1,3,and 6 months after operation,there was no significant difference in the VAS score,Cobb angle,and percentage of anterior and poste-rior margin of the injured vertebrae between the two groups(P>0.05).There was no significant difference between the VAS scores(P>0.05).The percentage improvement of the height of the anterior and posterior margins of the Cobb angle and the in-jured vertebral body was better than that of the observation group(P<0.05).Conclusion One week after operation,the back pain could be relieved obviously,and the morphology of the vertebral body is restored.The early clinical effect is exact.Co

关 键 词：经皮椎弓根钉内固定 经皮椎体后凸成形术 自固化磷酸钙骨水泥 骨质疏松 脊柱骨折 

分 类 号：R687.3[医药卫生—骨科学]