单侧经皮椎体后凸成形术联合过伸复位法治疗新鲜骨质疏松性椎体压缩性骨折的效果观察  

Effect of unilateral percutaneous kyphoplasty combined with hyperextension reduction in the treatment of fresh osteoporotic vertebral compression fractures

作　　者：彭亚[1] 肖辉灯 祝永刚[1] 郑皓云 柳根哲[1] 李春根 Peng Ya;Xiao Huideng;Zhu Yonggang;Zheng Haoyun;Liu Genzhe;Li Chungen(Department of Orthopaedics,Beijing Traditional Chinese Medicine Hospital,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院骨科,100010

出　　处：《中国综合临床》2021年第5期438-443,共6页Clinical Medicine of China

摘　　要：目的比较单侧与双侧经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)联合过伸复位法治疗新鲜骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的效果及临床意义。方法选取2018年1-12月就诊于首都医科大学附属北京中医医院的OVCF患者,对其临床资料进行回顾性分析。共纳入患者62例,根据手术入路方式将62例患者分成单侧穿刺入路组和双侧穿刺入路组,每组各31例。单侧穿刺入路组患者采用肢体过伸复位联合单侧PKP术。双侧穿刺入路组采用肢体过伸复位联合双侧PKP术。采用重复测量方差分析对两组患者术前、术后1 d、术后2周视觉模拟评分法(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、椎体前缘高度、椎体中线高度、Cobb角的变化进行观察比较。同时对两组患者的手术时间、术中透视次数、术中骨水泥注入量及不良反应情况进行比较。结果单侧穿刺入路组患者术前、术后1 d、术后2周VAS评分分别为(8.10±0.17)、(2.20±0.26)、(1.90±0.39)分,双侧穿刺入路组分别为(8.10±0.13)、(2.30±0.26)、(2.00±0.30)分,重复测量方差分析结果表明,F组内=13790.444、P<0.001,F组间=1.951、P=0.168,F交互=0.735、P=0.481。两组患者术后1 d、术后2周VAS评分与术前比较,差异均有统计学意义(P均<0.05);两组患者术后1 d VAS评分与术后2周比较,差异均有统计学意义(P均<0.05)。单侧穿刺入路组患者术前、术后1 d、术后2周ODI评分分别为(40.30±5.30)、(23.20±3.40)、(22.30±4.49)分,双侧穿刺入路组分别为(41.00±4.49)、(21.90±2.48)、(20.70±5.70)分,重复测量方差分析结果表明,F组内=339.046、P<0.001,F组间=1.385、P=0.244,F交互=1.083、P=0.342。两组患者术后1 d、术后2周ODI评分与术前比较,差异均有统计学意义(P均<0.05);两组患者术后1 d ODI评分与术后2周比较,差异均有统计学意义(P均<0.05)。单�Objective To compare the effect and clinical significance of unilateral and bilateral percutaneous kyphoplasty(PKP)combined with hyperextension reduction in the treatment of fresh osteoporotic vertebral compression fracture(OVCF).Methods The clinical data of OVCF patients treated in Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University from January to December 2018 were retrospectively analyzed.A total of 62 patients were included.According to the surgical approach,62 patients were divided into unilateral puncture approach group and bilateral puncture approach group,with 31 cases in each group.The patients in the unilateral puncture group were treated with limb hyperextension reduction combined with unilateral PKP.In the bilateral puncture approach group,limb hyperextension reduction combined with bilateral PKP was used.The changes of visual analogue pain scale(VAS),Oswestry disability index(ODI),vertebral anterior height,vertebral midline height and Cobb angle were observed and compared before operation,1 day and 2 weeks after operation.At the same time,the operation time,intraoperative fluoroscopy times,intraoperative bone cement injection and adverse reactions were compared between the two groups.Results The VAS scores of patients in the unilateral puncture approach group before operation,1 day and 2 weeks after operation were(8.10±0.17),(2.20±0.26)and(1.90±0.39),respectively.The scores of bilateral puncture approach group were(8.10±0.13),(2.30±0.26)and(2.00±0.30),respectively.The results of repeated measurement ANOVA showed that F intra-group=13790.444,P<0.001,F inter-group=1.951,P=0.168,F interaction=0.735,P=0.481.There were significant differences in VAS scores between the two groups 1 day and 2 weeks after operation(all P<0.05).There was significant difference in VAS score between the two groups 1 day after operation and 2 weeks after operation(all P<0.05).The ODI scores of patients in the unilateral puncture group before operation,1 day and 2 weeks after operation we

关 键 词：骨质疏松性椎体压缩性骨折 单侧经皮椎体后凸成形术 双侧经皮椎体后凸成形术 过伸复位法 

分 类 号：R687.3[医药卫生—骨科学]