短节段椎弓根钉内固定联合椎体成形术治疗OF 5型骨质疏松性胸腰椎骨折疗效观察  

Short-segment pedicle screw fixation combined with vertebral plasty for treatment of OF type 5 osteoporotic thoracolumbar vertebral fractures

作　　者：钱玉强 王强 江龙 李法年 QIAN Yuqiang;WANG Qiang;JIANG Long;LI Fanian(Department of Orthopedics,the Affiliated Yixing Hospital of Jiangsu University,Yixing,Jiangsu 214200,China)

机构地区：[1]江苏大学附属宜兴医院(宜兴市人民医院)脊柱外科,江苏214200

出　　处：《中国骨与关节损伤杂志》2024年第1期22-26,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的 观察短节段椎弓根钉内固定联合椎体成形术治疗OF 5型骨质疏松性胸腰椎骨折的疗效。方法 回顾性分析自2013-05—2020-12诊治的24例合并后方韧带复合体、后柱骨性结构损伤或前方张力带损伤的OF 5型骨质疏松性胸腰椎骨折,采用后路短节段椎弓根钉内固定联合椎体成形术治疗。比较手术前后腰背部疼痛VAS评分、骨折椎体前缘高度比值、Cobb角的差异。结果 24例均获得随访,随访时间24~50个月,平均29个月。骨折均愈合良好,未出现内固定拔出、断裂、弯曲等情况,无椎体塌陷。术前、术后1周及末次随访时腰背部疼痛VAS评分、骨折椎体前缘高度比值、Cobb角差异有统计学意义(P<0.05)。术后1周疼痛VAS评分较术前降低(P<0.05),末次随访时疼痛VAS评分较术后1周继续降低(P<0.05)。术后1周骨折椎体前缘高度比值较术前增加(P<0.05),末次随访时骨折椎体前缘高度比值有所降低,但是与术后1周比较差异无统计学意义(P>0.05)。术后1周Cobb角较术前减小(P<0.05),末次随访时Cobb角有所丢失,但是与术后1周比较差异无统计学意义(P>0.05)。结论 短节段椎弓根钉内固定联合椎体成形术治疗OF 5型骨质疏松性胸腰椎骨折可以早期增强脊柱的稳定性,避免骨折椎体高度和Cobb角丢失,患者可以早期活动以避免长期卧床导致的并发症。Objective To observe the efficacy of short-segment pedicle screw fixation combined with vertebral plasty for the treatment of OF type 5 osteoporotic thoracolumbar vertebral fractures.Methods A retrospective analysis was conducted on 24 cases of OF type 5 osteoporotic thoracolumbar vertebral fractures with posterior ligament complex injury,or posterior column bone structure injury,or anterior tension band injury treated with posterior short-segment pedicle screw fixation combined with vertebral plasty from May 2013 to December 2020.The differences in VAS scores for back pain,ratio of anterior body height of injured vertebra,and Cobb angle were compared before and after surgery.Results All 24 cases were followed up for 24 to 50 months,29 months on average.All fractures healed well without any internal fixation extraction,fracture,or bending,and there was no vertebral collapse.There were statistically significant differences in VAS scores for back pain,ratio of anterior body height of injured vertebra,and Cobb angle before surgery,1 week after surgery,and at the last follow-up(P<0.05).The VAS score decreased one week after surgery compared with that before surgery(P<0.05).At the last follow-up,the VAS score also significantly improved compared with that one week after surgery(P<0.05).The ratio of anterior body height of injured vertebra increased one week after surgery compared with that before surgery(P<0.05).At the last follow-up,the ratio of anterior body height of injured vertebra decreased,but there was no statistically significant difference compared with that one week after sur⁃gery(P>0.05).The Cobb angle decreased one week after surgery compared with that before surgery(P<0.05),and there was some loss of Cobb angle at the last follow-up,but there was no statistically significant difference compared with that one week after surgery(P>0.05).Conclusion Short-segment pedicle screw fixation combined with vertebral plasty for the treatment of OF type 5 osteoporotic thoracolumbar vertebral fractures can enhance s

关 键 词：胸腰椎骨折 骨质疏松 后方韧带复合体 OF分型 椎弓根钉 内固定 椎体成形术 

分 类 号：R687.3[医药卫生—骨科学]