不同复位策略结合经皮椎体成形术治疗老年单节段胸腰椎骨质疏松性椎体压缩性骨折  

Different reduction strategies combined with percutaneous vertebroplasty for treatment of singlesegment thoracolumbar osteoporotic vertebral compression fractures in elderly

作　　者：王亮 王璨[2] 杨海松 卢旭华 Wang Liang;Wang Can;Yang Haisong;Lu Xuhua(Department of Orthopaedics,Changzheng Hospital,Naval Medical University,Shanghai 200003,China;Basic Medical College,North Sichuan Medical College,Nanchong 637100,Sichuan,China;School of Health Science and Engineering,Shanghai University of Technology,Shanghai 200433,China)

机构地区：[1]海军军医大学长征医院骨科,上海200003 [2]川北医学院基础医学院,南充637100 [3]上海理工大学健康科学与工程学院,上海200433

出　　处：《脊柱外科杂志》2023年第3期151-154,161,共5页Journal of Spinal Surgery

基　　金：上海市科学技术委员会科研计划项目(19140901400);上海市医学领军人才培养计划项目(2019LJ14)。

摘　　要：目的探讨不同复位策略结合经皮椎体成形术(PVP)治疗老年单节段胸腰椎骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法2019年3月—2021年3月,海军军医大学长征医院收治老年单节段胸腰椎OVCF患者84例,其中54例采取手法复位结合PVP治疗(手法复位组),30例采用单纯PVP治疗(传统组)。记录术中骨水泥注入量及术后骨水泥渗漏情况;测量手术前后伤椎Cobb角及伤椎前缘高度,计算伤椎前缘高度恢复率;采用疼痛视觉模拟量表(VAS)评分评价疼痛程度。结果所有手术顺利完成,患者随访>12个月。手法复位组术中骨水泥注入量明显大于传统组,差异有统计学意义(P<0.05);但2组骨水泥渗漏率差异无统计学意义(P>0.05)。2组术后伤椎Cobb角、伤椎前缘高度及VAS评分较术前显著改善,手法复位组改善情况优于传统组,差异均有统计学意义(P<0.05)。结论手法复位结合PVP治疗老年单节段胸腰椎OVCF临床效果良好,可更有效地恢复椎体高度,维持脊柱序列稳定性,改善患者临床症状。Objective To investigate the clinical efficacy of different reduction srtategies combined with percutaneous vertebroplasty(PVP)in the treatment of single-segment thoracolumbar osteoporotic vertebral compression fractures(OVCF)in the elderly.Methods From March 2019 to March 2021,84 elderly patients with single-segment thoracolumbar OVCF were treated in Changzheng Hospital,of which 54 cases were treated with manual reduction combined iwth PV(P manual reduction group),and 30 with simple PV(Ptraditional group).The amount of bone cement injected during operation and thee alkage of bone cement after operation were recorded;the Cobb angle and anterior height of injured vertebra were mseuared before and after operation,and the recovery rate of anterior height of injured vertebra sw acalculated;the visual analogue scal(e VAS)was used to evaluate the pain intensity.R esults All the operations were successfully completed,and the patients were followed up for more than 12 months.The amount of bone cement injecteidn manual reduction group was significantly higher than tha t in traditional group,with a statistical significanc(eP<0.05),but there was no significant difference between the 2 groups in bone cement leakage rat(e P>0.05).The Cobb angle of injured vertebra,anterior height of injured vertebra and VAS scor e were significantly improved in both groups after operation comapred with those before operation,and the improvement in manual reduction group was better than that in traditional group,with a statistical significance(P<0.05).Conclusion Manual reduction combined with PVP has a good clinical effect in ther etatment of elderly single-segment thoracolumbar OVCF,which can more effectively restore the height of the vertebral bodym,aintain the stability of the spinal sequence,and improve the clinical symptoms of patients.

关 键 词：胸椎 腰椎 骨折 压缩性 骨质疏松 椎体成形术 

分 类 号：R682.3[医药卫生—骨科学]