球囊扩张联合撬拨复位植骨治疗青中年胸腰椎压缩性骨折的临床研究  

Clinical study of balloon expansion kyphoplasty combined with poking reduction and bone grafting in the treatment of young and middle-aged thoracolumbar compression fractures

作　　者：姚雪莹 贺银川 刘明昊 曹鹏 魏然 许俊岭[1] 张丽[1] 赵爱军[1] 季海龙[1] 张建华[1] YAO Xue-ying;HE Yin-chuan;LIU Ming-hao;CAO Peng;WEI Ran;XU Jun-ling;ZHANG Li;ZHAO Ai-jun;JI Hai-long;ZHANG Jian-hua(Department of Orthopaedics and Traumatology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061000,Hebei,China)

机构地区：[1]沧州中西医结合医院骨伤科,河北沧州061000

出　　处：《广东医学》2023年第8期991-997,共7页Guangdong Medical Journal

基　　金：河北省医学科学研究课题(20200612)。

摘　　要：目的探讨球囊扩张椎体后凸成形联合撬拨复位植骨内固定术在青中年胸腰椎压缩性骨折中的应用价值。方法选取2018年5月至2020年5月收治的80例青中年胸腰椎压缩性骨折患者随机分为观察组与对照组,各40例。观察组行球囊扩张椎体后凸成形联合撬拨复位植骨内固定术治疗,对照组行常规经后路椎弓根钉棒系统复位内固定术治疗。比较两组手术时间、术中出血量、术后引流量和住院时间、伤椎椎体前缘高度、Cobb角及并发症发生率,采用Oswestry功能障碍指数(ODI)评价受试对象功能障碍的严重程度,视觉模拟评分法(VAS)评估疼痛程度。结果观察组手术时间长于对照组(P<0.05),术中出血量、术后引流量、住院时间低于对照组(P<0.05)。两组术后和末次随访伤椎椎体前缘高度均高于术前(P<0.05),Cobb角低于术前(P<0.05);但对照组末次随访较术后伤椎椎体前缘高度和Cobb角均有一定丢失,末次随访伤椎椎体前缘高度比较观察组高于对照组(P<0.05),Cobb角低于对照组(P<0.05)。两组术后和末次随访ODI、疼痛VAS评分均低于术前(P<0.05),术后和末次随访ODI、疼痛VAS评分比较观察组低于对照组(P<0.05)。两组术后并发症发生率差异无统计学意义(P>0.05)。结论球囊扩张椎体后凸成形联合撬拨复位植骨内固定术可有效地矫正青中年胸腰椎压缩性骨折患者伤椎前缘高度与Cobb角,促进术后功能恢复,减轻疼痛程度,且手术创伤小,术中出血少,术后恢复快。Objective To investigate the application value of balloon expansion kyphoplasty combined with lever reduction and bone grafting in the treatment of thoracolumbar compression fractures in young and middle-aged patients.Methods Eighty cases of thoracolumbar compression fractures in middle-aged and young adults from May 2018 to May 2020 were randomly divided into observation group(n=40)and control group(n=40).Patients on the observation group underwent balloon expansion,kyphoplasty,lever reduction,and bone grafting internal fixation,while those in the control group underwent conventional posterior pedicle screw and rod system reduction internal fixation.Surgical time,intraoperative blood loss,postoperative drainage,hospitalization time,anterior vertebral height of the injured vertebrae,Cobb angle,and complication rates were compared between the two groups.The Oswestry Disability Index(ODI)was used to evaluate the severity of functional impairment,and the Visual Analog Scale(VAS)was used to assess pain levels in the subjects.Results The surgical time in the observation group was longer than that in the control group(P<0.05),while intraoperative blood loss,postoperative drainage,and hospitalization time were lower in the observation group than those in the control group(P<0.05).Both groups showed increased anterior vertebral height of the injured vertebrae and decreased Cobb angle after surgery and at the last follow-up(P<0.05).However,the control group had a certain degree of loss in anterior vertebral height and Cobb angle at the last follow-up compared to immediately after surgery.The anterior vertebral height at the last follow-up was higher in the observation group than in the control group(P<0.05),while the Cobb angle was lower in the observation group than in the control group(P<0.05).Both groups showed decreased ODI and VAS scores after surgery and at the last follow-up compared to preoperative scores(P<0.05).The ODI and VAS scores at the last follow-up were lower in the observation group than in the control g

关 键 词：球囊扩张椎体后凸成形术 撬拨复位植骨内固定术 胸腰椎压缩性骨折 青中年 

分 类 号：R687.3[医药卫生—骨科学] R285.6[医药卫生—外科学]