过伸悬吊复位与PVP协同作用于老年骨质疏松性椎体压缩骨折临床效能分析  

Clinical efficacy analysis of hyperextension reduction combined with percutaneous vertebroplasty on elderly osteoporotic vertebral compression fractures

作　　者：杨智奎 王一公 王德民 周锦鸽 菅炎鹏 梁晨 邵欣慰 徐松山 YANG Zhi-kui;WANG Yi-gong;WANG De-min;ZHOU Jin-ge;JIAN Yan-peng;LIANG Chen;SHAO Xin-wei;XU Song-shan

机构地区：[1]许昌市中心医院脊柱脊髓外科,河南许昌461000

出　　处：《中国疗养医学》2023年第6期626-629,共4页Chinese Journal of Convalescent Medicine

基　　金：许昌市科技攻关项目(20190213183)。

摘　　要：目的 分析对比单纯的经皮椎体成形术(PVP)疗法与过伸悬吊复位联合PVP方法治疗老年骨质疏松性椎体压缩骨折(OVCF)的疗效差别。方法 选取2017年12月至2019年12月就诊于许昌市中心医院诊断为老年骨质疏松性椎体压缩骨折,按照随机数字表分为对照组和观察组。对照组采用单纯PVP治疗,观察组采用过伸复位+PVP治疗。治疗结束后,对比分析两组的临床疗效,如疼痛视觉模拟评分量表(VAS)评分、Cobb角、椎体前缘高度、腰椎功能障碍指数(ODI)等。结果 术前对照组与观察组的VAS评分、Cobb角、椎体前缘高度、ODI组间差异无统计学意义,术后3 d观察组的VAS(1.80±0.68)分、Cobb角(13.82±1.73)°、ODI(33.99±2.75)分低于对照组VAS(2.30±0.85)分、Cobb角(16.80±2.49)°、ODI (38.03±3.19)分,观察组的椎体前缘高度(24.11±1.48)mm高于对照组(20.90±3.42)mm,术后6个月,观察组的VAS(1.12±0.56)分、Cobb角(14.58±1.46)°、ODI(23.35±2.65)分低于对照组VAS(1.52±0.73)分、Cobb角(17.61±1.83)°、ODI (27.80±7.14)分,观察组的椎体前缘高度(23.75±1.48)mm高于对照组(19.76±1.76)mm,且差异具有统计学意义(P<0.05)。结论 对于老年骨质疏松性压缩骨折患者,单纯的PVP与过伸复位+PVP治疗都能减轻患者痛苦,恢复伤椎前缘高度,改善腰椎活动功能,但后者更能减轻患者痛苦,减少后期后凸畸形发生概率,增强腰椎活动灵活度,对患者具有较好的临床疗效。Objective To compare the efficacy of percutaneous vertebroplasty(PVP)therapy alone and hyperextension reduction combined with PVP in the treatment of elderly osteoporotic vertebral compression fractures(OVCF).Methods The OVCF patients diagnosed in Xuchang Central Hospital from December 2017 to December 2019 were enrolled in this study,and they were randomly assinged observation group and control group.The control group was treated with PVP alone,and the observation group was treated with the combination of PVP and hyperextension reduction.After treatment,the clinical effects of the two groups were compared,such as the visual analogue scale(VAS),Cobb angle,anterior edge height of vertebral body and Oswestry disability index(ODI).Results There were no significant differences in VAS,Cobb angle,anterior edge height of vertebral body and ODI between the two groups before operation.Three days after operation,VAS,Cobb angle,and ODI in the observation group were significantly lower than those in the control group(VAS:[1.80±0.68]points VS[2.30±0.85]points,Cobb angle:[13.82±1.73]°VS[16.80±2.49]°and ODI:[33.99±2.75]points VS[38.03±3.19]points).Meanwhile,the anterior edge height of vertebral body in the observation group was significantly higher than that in the control group(24.11±1.48)mm VS(20.90±3.42)mm.Six months after operation,the VAS(1.12±0.56)points VS(1.52±0.73)points,Cobb angle(14.58±1.46)°VS(17.61±1.83)°and ODI(23.35±2.65)points VS(27.80±7.14)points in the observation group were significantly lower than those in the control group;the anterior edge height of vertebral body in the observation group was significantly higher than that in the control group(23.75±1.48)mm VS(19.76±1.76)mm,P<0.05.Conclusion For elderly patients with OVCF,PVP alone and the combination of hyperextension reduction and PVP can both alleviate pain,restore the height of the anterior edge of the injured vertebra,and improve the lumbar movement function.However,the combination of hyperextension reduction and PVP has an advanta

关 键 词：椎体压缩性骨折 老年骨质疏松 经皮椎体成形术 过伸悬吊复位 

分 类 号：R687.3[医药卫生—骨科学]