后路椎弓根钉固定结合椎体成形术治疗老年骨质疏松性胸腰椎爆裂骨折  

Treatment of osteoporotic thoracolumbar burst fractures in the elderly by posterior pedicle screw fixation combined with vertebroplasty

作　　者：黎树佳 陈志军[1] 伍志健 丁小科 邓征智 黄绍贤[1] LI Shujia;CHEN Zhijun;WU Zhijian;DING Xiaoke;DENG Zhengzhi;HUANG Shaoxian(Department of Orthopaedics,The Second People's Hospital of Zhaoqing City,Zhaoqing,Guangdong 526040,China)

机构地区：[1]肇庆市第二人民医院骨科,广东526040

出　　处：《中国骨科临床与基础研究杂志》2021年第3期103-107,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探讨后路椎弓钉固定结合椎体成形术治疗老年骨质疏松性胸腰椎爆裂骨折患者的临床效果。方法回顾性分析广东省肇庆市第二人民医院2017年1月至2020年1月收治的62例老年骨质疏松性胸腰椎爆裂骨折患者的临床资料,其中对照组30例,单纯行椎体成形术治疗,观察组32例,采用椎体成形术联合后路椎弓根钉固定,比较两组患者影像学及临床治疗效果差异。结果术后1 d、6个月两组患者视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)均较术前改善,且观察组术后各时相点指标均优于对照组(P<0.05);两组术后6个月椎体前缘压缩率、后缘压缩率和Cobb角均较术前改善,且观察组术后6个月上述指标均优于对照组(P<0.05);观察组治疗总有效率(94%)高于对照组(73%)。结论后路椎弓根钉固定结合椎体成形术治疗可有效恢复骨折椎体高度,矫正后凸畸形,缓解疼痛症状,改善脊柱功能,短期效果满意,是治疗骨质疏松性胸腰椎爆裂骨折的较好选择。Objective To investigate the clinical effect of posterior pedicle screw fixation combined with vertebroplasty for elderly patients with osteoporotic thoracolumbar burst fractures.Methods Clinical data of 62 elderly patients with osteoporotic thoracolumbar burst fractures treated in the Second People's Hospital of Zhaoqing City from Jan 2017 to Jan 2020 were retrospectively analyzed.Patients in the control group(n=30)were treated with vertebroplasty alone,while patients in the observation group(n=32)were treated with posterior pedicle screw fixation combined with vertebroplasty.Differences of radiological parameters and clinical outcome were compared between two groups.Results Visual analogue scale(VAS)score and Oswestry disability index(ODI)at 1 day and 6 months after the operation all improved when compared with preoperative ones in both groups,furthermore,indicators at different timepoint after the surgery in observation group were better than those in control group(P<0.05).The compression ratio of the anterior,posterior vertebral body as well as Cobb angle at 6 months postoperatively in two groups all improved when compared with preoperative ones,and the above postoperative parameters in observation group were all lower than those in control group(P<0.05).Total effective rate of treatment in the observation group(94%)was also higher than that in control group(73%).Conclusion Posterior pedicle screw fixation combined with vertebroplasty is a good choice to elderly patients with osteoporotic thoracolumbar burst fractures which could effectively restore the height of fractured vertebrae,correct the kyphotic deformity,relieve the patients'pain,and improve the spinal function with good short-term efficacy.

关 键 词：骨质疏松性骨折 脊柱骨折 胸椎 腰椎 骨折固定术 内 椎体成形术 椎弓根钉 老年人 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]