经皮穿刺脊柱后凸成形术和经椎弓根开合式截骨术治疗陈旧性腰胸段骨折伴后凸畸形的效果比较  

Comparison of Percutaneous Kyphoplasty and Transpedicular Osteotomy in the Treatment of Old Thoracolumbar Fractures with Kyphosis

作　　者：林鹏 陈伟 刘春新[1] 张诚毅[1] LIN Peng;CHEN Wei;LIU Chunxin;ZHANG Chengyi(Jian’ou Municipal Hospital,Jian’ou 353100,China;不详)

机构地区：[1]建瓯市立医院,福建建瓯353100 [2]厦门大学附属福州第二医院

出　　处：《中外医学研究》2021年第26期122-125,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究经皮穿刺脊柱后凸成形术与经椎弓根开合式截骨术的治疗方法在陈旧性腰胸段骨折伴后凸畸形中的临床效果。方法:选取本院2017年10月-2019年10月收治的陈旧性腰胸段骨折伴后凸畸形患者94例,按照其手术方法分为研究组(45例,行经椎弓根开合式截骨术)与对照组(49例,行经皮穿刺脊柱后凸成形术)。记录两组术前及术后2、4、6个月疼痛变化情况,比较两组术前及术后6个月椎体高度及后凸度角恢复情况、两组术前及术后2、4、6个月肢体功能变化及手术并发症情况。结果:两组术前视觉模拟评分法(visual analogue scale,VAS)评分差异无统计学意义(P>0.05),术后研究组VAS评分显著低于对照组(P<0.05);两组术前椎体中间高度、椎体前壁、椎体后壁及后凸角度差异无统计学意义(P>0.05),术后研究组椎体中间高度、椎体前壁及椎体后壁高于对照组(P<0.05),后凸角度小于对照组(P<0.05);两组术前Oswestry功能障碍指数问卷表(Oswestry disability index,ODI)评分差异无统计学意义(P>0.05),术后研究组ODI评分显著低于对照组(P<0.05);研究组并发症发生率为15.55%,低于对照组的20.41%,但差异无统计学意义(P>0.05)。结论:经椎弓根开合式截骨术较经皮穿刺脊柱后凸成形术治疗陈旧性腰胸段骨折患者更能有效改善患者疼痛症状,恢复脊柱正常生理功能。Objective:To study the clinical effect of percutaneous kyphoplasty and transpedicular osteotomy in the treatment of old thoracolumbar fractures with kyphosis.Method:A total of 94 cases of old thoracolumbar fracture with kyphosis in our hospital from October 2017 to October 2019 were selected as the research objects,and they were divided into the study group(45 cases,treated with pedicle osteotomy)and the control group(49 cases,treated with percutaneous kyphosis).The changes of pain before and after 2,4 and 6 months were recorded and compared between the two groups.The recovery of vertebral height and crown angle before and 6 months after operation,the changes of limb function before and 2,4 and 6 months after operation,and the occurrence of surgical complications were compared between the two groups.Result:There was no significant difference in the preoperative visual analogue scale(VAS)score between the two groups(P>0.05),and after operation,the VAS score of the study group was significantly lower than that of the control group(P<0.05);there were no significant differences in the middle height,anterior wall,posterior wall and kyphosis angle of the two groups before operation(P>0.05),but after operation,the middle height,anterior wall and posterior wall of the study group were higher than those of the control group(P<0.05),and the kyphosis angle of the study group was lower than that of the control group(P<0.05).The ODI score of the two groups before operation had no significant difference(P>0.05),and the ODI score of the study group after operation was significantly lower than that of the control group(P<0.05);the complication rate of the study group was 15.55%,which was lower than 20.41%of the control group,but the difference was not statistically significant(P>0.05).Conclusion:Transpedicular osteotomy is more effective in improving the pain symptoms and restore the normal physiological function of spine in patients with old lumbar and thoracic fractures than percutaneous kyphoplasty.

关 键 词：经皮穿刺脊柱后凸成形术 经椎弓根开合式截骨术 陈旧性腰胸段骨折 

分 类 号：R687.3[医药卫生—骨科学]