改良悬吊复位法联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折的临床研究  

Clinical study of modified suspension reduction method combined with percutaneous vertebroplasty in the treatment of thoracolumbar osteoporotic compression fracture

作　　者：鲁玉州 王雨[1] 杨晓旭 吴成强 张守翠 王金国[1] 吴亚东[1] 秦东[1] 丁林 LU Yu-zhou;WANG Yu;YANG Xiao-xu;WU Cheng-qiang;ZHANG Shou-cui;WANG Jin-guo;WU Ya-dong;QIN Dong;DING Lin(Rizhao Hospital of Traditional Chinese Medicine Affiliated to Shandong Traditional Chinese Medicine University,Rizhao 276800,Shandong,China)

机构地区：[1]山东中医药大学附属日照市中医医院,山东日照276800

出　　处：《中国骨伤》2024年第1期21-26,共6页China Journal of Orthopaedics and Traumatology

基　　金：山东省中医药科技发展计划项目(编号:2022M165)。

摘　　要：目的:探讨改良悬吊复位法联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折的临床疗效。方法:自2020年2月至2021年10月采用经皮椎体成形术治疗胸腰椎骨质疏松性压缩骨折患者92例,按照治疗方式不同分为观察组和对照组,观察组先行改良悬吊复位法给予伤椎复位,再行经皮椎体成形术治疗,对照组则单纯给予经皮椎体成形术治疗。观察组47例,男20例,女27例;年龄59~76(69.74±4.50)岁;骨折椎体节段T_(10)2例,T_(11)7例,T_(12)19例,L_(11)4例,L25例;对照组45例,男21例,女24例;年龄61~78(71.02±3.58)岁;骨折椎体节段:T_(10)3例,T_(11)8例,T_(12)17例,L_(11)2例,L_(2)5例。观察术中骨水泥渗漏情况,记录并比较两组手术前后疼痛视觉模拟评分(visual analogue scale,VAS)、腰椎Oswestry功能障碍指数(Oswestry disability index,ODI)、伤椎前缘高度、伤椎后凸Cobb角及骨水泥注入量等指标。结果:所有患者获得随访,时间6~10(8.45±1.73)个月。观察组2例出现骨水泥渗漏,对照组3例出现骨水泥渗漏。观察组术后伤椎前缘高度较术前均增加(P<0.05),伤椎后凸Cobb角较术前降低(P<0.05);对照组术后伤椎后凸Cobb角及伤椎前缘高度与术前比较,差异无统计学意义(P>0.05);观察组术后伤椎后凸Cobb角(9.82±2.55)°,低于对照组(15.87±4.60)°(P<0.05),伤椎前缘高度观察组(21.29±3.65)mm,高于对照组(17.16±2.91)mm(P<0.05)。观察组VAS术前(7.32±1.05)分,术后1周及3、6个月分别为(3.56±1.18)、(1.83±0.67)、(1.27±0.34)分,ODI评分术前(40.12±14.69)分,术后1周及3、6个月分别为(23.76±10.19)、(20.15±6.39)、(13.45±3.46)分。对照组VAS术前(7.11±5.26)分,术后1周及3、6个月分别为(3.82±0.68)、(1.94±0.88)、(1.36±0.52)分,ODI评分术前(41.38±10.23)分,术后1周及3、6个月分别为(25.13±14.22)、(20.61±5.82)、(14.55±5.27)分。两组术后VAS、ODI评分较术前均下降(P<0.05),术后两组VAS及ODI比较,差异无统计学意义(P>0.Objective To investigate the clinical effect of modified suspension reduction method combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures.Methods From February 2020 to October 2021,92 patients with thoracolumbar osteoporotic compression fracture were treated by percutaneous vertebroplasty.According to different treatment methods,they were divided into the observation group and the control group.The observation group was treated with modified suspension reduction and then percutaneous vertebroplasty,while the control group was treated with percutaneous vertebroplasty alone.The observation group(47 cases),including 20 males and 27 females,the age ranged from 59 to 76 years old with an average of(69.74±4.50)years old,fractured vertebral bodies:T_(10)(2 cases),T_(11)(7 cases),T_(12)(19 cases),L_(1)(14 cases),L_(2)(5 cases);the control group(45 cases),including 21 males and 24 females,the age ranged from 61 to 78 years old with an average of(71.02±3.58)years old,fractured vertebral bodies:T_(10)(3 cases),T_(11)(8 cases),T_(12)(17 cases),L_(1)(12 cases),L_(2)(5 cases);The leakage of bone cement were observed,the visual analogue scale(VAS),Oswestry lumbar dysfunction index(ODI),anterior vertebrae height(AVH),Cobb angle of kyphosis and the amount of bone cement injected before and after operation were recorded and compared between the two groups.Results All patients were followed up,ranged from 6 to10 with an average of(8.45±1.73)months.Two patients ocurred bone cement leakage in observation group and 3 patients in control group.AVH of observation group increased(P<0.05)and Cobb angle of injured vertebrae decreased(P<0.05).Cobb angle of injured vertebrae and AVH of the control group were not significantly changed(P>0.05).Cobb angle of injured vertebrae of the observation group was lower than that of control group(P<0.05)and AVH was higher than that of the control group(P<0.05).In the observation group,VAS before operation and 1 week,3 and 6 months after operati

关 键 词：悬吊复位法 胸腰椎 骨质疏松性骨折 压缩性骨折 

分 类 号：R274.13[医药卫生—中医骨伤科学]