顺势动态复位联合微型交锁骨水泥技术椎体成形术治疗骨质疏松性胸腰椎压缩骨折疗效观察  

Observation of efficacy of homeopathic dynamic reduction and microinterlocking vertebroplasty in treatment of osteoporotic thoracolumbar vertebral compression fractures

作　　者：彭国常[1] 王强[2] 蒋晓伟[2] 罗斌 沈影超[2] PENG Guochang;WANG Qiang;JIANG Xiaowei;LUO Bin;SHEN Yingchao(Department of Orthopedics,Tianchang Municipal First People's Hospital,Chuzhou,Anhui 239300,China;不详)

机构地区：[1]天长市人民医院骨科,安徽滁州239300 [2]南京中医药大学常熟附属医院骨科,江苏215500

出　　处：《中国骨与关节损伤杂志》2023年第9期907-911,共5页Chinese Journal of Bone and Joint Injury

基　　金：常熟市卫生健康委员会科技计划项目(csws201928);苏州市临床重点病种诊疗技术专项项目(LCZX201923);2020年常熟市科技局科技发展计划项目(CS202001)。

摘　　要：目的 观察顺势动态复位联合微型交锁骨水泥技术椎体成形术治疗骨质疏松性胸腰椎压缩骨折的临床疗效,评估该技术提高骨折椎体的复位质量和长期力学稳定性的效果。方法 纳入自2019-06-2021-06在南京中医药大学常熟附属医院和天长市人民医院手术治疗的46例骨质疏松性椎体压缩骨折,观察组22例采用顺势动态手法复位微型交锁椎体成形术治疗,对照组24例采用常规经皮椎体后凸成形术治疗。比较两组手术时间、骨水泥渗漏发生率、疼痛VAS评分、伤椎椎体前缘高度恢复比值、伤椎椎体前缘高度丢失比值。结果 46例均获得随访,随访时间为6~7个月,平均6.3个月。观察组术后X线片显示18例骨水泥形成“蛋壳”样结构,20例骨水泥团块边缘形成毛刺状结构,17例骨水泥团块外留有“球拍状”结构,随访期间未出现骨水泥团块移位的情况。观察组手术操作时间较对照组长,骨水泥渗漏发生率低于对照组,术后6个月伤椎椎体前缘高度丢失比值小于对照组,差异有统计学意义(P<0.05)。观察组与对照组术后第1天伤椎椎体前缘高度恢复比值、术后第2天疼痛VAS评分差异无统计学意义(P>0.05)。结论 骨质疏松性椎体压缩骨折经皮椎体后凸成形术可以采用顺势动态复位、微型交锁骨水泥技术理论进行指导,合理应用“蛋壳”球囊优化成形、温度梯度技术和“球拍”技术,术后可以获得即刻稳定性,同时获得更好的远期临床疗效。Objective To observe the clinical efficacy of homeopathic dynamic reduction and microinterlocking vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures and evaluate the effect of this technique on the reduction quality and long-term mechanical stability of vertebral fractures.Methods Forty-six patients with osteoporotic vertebral com-pression fractures who were surgically treated in Changshu Affiliated Hospital of Nanjing University Chinese Medicine and Tian-chang People's Hospital from June 2019 to June 2021 were included.Twenty-two patients in the observation group were treated with homeopathic dynamic manual reduction combined with micro-interlocking vertebroplasty while 24 patients in the control group were treated with conventional percutaneous kyphoplasty.Operation time,incidence of bone cement leakage,pain VAS score,ratio of anterior margin height recovery and ratio of anterior margin height loss of injured vertebra were compared between the two groups.ResultsAll 46 cases were followed up for 6-7 months,with an average of 6.3 months.Postoperative X-ray films of the observation group showed that the"eggshell-like"structure was formed in 18 cases of bone cement,the edge of the bone cement mass was formed in 20 cases,and the"racket-like"structure was left outside the bone cement mass in 17 cases.There was no displacement of the bone cement mass during follow-up.The operation time of the observation group was longer than that of the control group,the incidence of bone cement leakage was lower than that of the control group,and the ratio of ver-tebral anterior margin height loss of the injured vertebra at the end of 6 months after surgery was lower than that of the control group,the difference was statistically sigificant(P<0.05).There was no significant dfference between the observation group and the control group in the ratio of vertebral anterior margin height recovery and the pain VAS score of the injured vertebra on day 1 after surgery(P>0.05).Conclusion Percutaneous kyphoplas

关 键 词：骨质疏松性椎体压缩骨折 胸腰椎骨折 经皮椎体后凸成形术 顺势动态复位 微型交锁 

分 类 号：R687.3[医药卫生—骨科学]