椎体后凸成形术联合小关节突封闭治疗单节段椎体压缩性骨折的临床疗效  

Clinical efficacy of percutaneous kyphoplasty combined with facet joint blocking in treatment of single-segment vertebral compression fractures

作　　者：王利元 程昀[1] 晏铮剑[1] 邹雨龙 吴宇航 WANG Li-yuan;CHENG Yun;YAN Zheng-jian;ZOU Yu-long;WU Yu-hang(Department of Orthopaedics,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院骨科

出　　处：《局解手术学杂志》2019年第6期465-469,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市卫生和计划生育委员会适宜卫生技术推广项目(2016jstg018);重庆市研究生科研创新基金(CYS16234)

摘　　要：目的探讨经皮穿刺椎体后凸成形术(PKP)联合小关节突封闭治疗老年单节段椎体压缩性骨折的临床效果。方法收集2018年1月至2019年1月我院收治的单节段椎体压缩性骨折患者72例,按手术方式的不同分为对照组和观察组,分别行单纯PKP和PKP联合小关节突封闭手术。应用疼痛视觉模拟指数VAS评分、功能障碍指数ODI评分分别评估患者术前、术后即刻、术后24h、术后72h、术后1个月临床疗效。结果观察组患者手术时间长于对照组,差异有统计学意义(P<0.05);2组患者术前VAS及ODI评分比较差异无统计学意义(P>0.05),术后各时间点VAS及ODI评分与术前相比均获得明显改善,差异有统计学意义(P<0.05),观察组患者在术后即刻、术后24h、术后72h改善较对照组明显,差异有统计学意义(P<0.01),但2组术后1个月VAS及ODI评分比较,差异无统计学意义(P>0.05)。结论PKP联合小关节突封闭治疗老年人群单节段椎体压缩性骨折早期疼痛缓解程度更好,能更早下地活动,明显提高患者手术疗效,减少并发症。Objective To compare the clinical outcomes of percutaneous kyphoplasty(PKP)combined with facet joint blocking in the treatment of elderly single-segment vertebral compression fracture.Methods A total of 72 patients with single-segment vertebral compression fractures who were diagnosed in our hospital from January 2018 to January 2019 were randomly divided into the control group and the observation group.PKP and PKP combined with small facet joints were performed in control group and observation group respectively.The pain visual analogue index VAS score and dysfunction index ODI score were used to evaluate the clinical efficacy in preoperative,postoperative immediately,24 hours,72 hours and 1 month.Results The operation time of the observation group was longer than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups in the VAS and ODI scores before operation(P>0.05).The VAS and ODI scores were significantly improved compared with those before operation at all postoperative time points,and the difference was statistically significant(P<0.05).The improvement of the observation group was more obvious at postoperative immediately,24 hours and 72 hours than those of control group,the difference was statistically significant(P<0.01),but there was no significant difference between the two groups at 1 month after surgery(P>0.05).Conclusion PKP combined with facet joint blocking for the treatment of single-segment vertebral compression fractures in the elderly has better relief of early pain,with the activity earlier,which can significantly improve the surgical outcome and reduce complications.

关 键 词：骨质疏松 单节段 椎体压缩性骨折 椎体后凸成形术 小关节突封闭 

分 类 号：R683.2[医药卫生—骨科学]