后路椎弓根钉内固定结合病椎骨水泥强化治疗老年性胸腰椎骨折的近远期疗效观察  

Observation of short-term and long-term effects of posterior pedicle screw internal fixation combined with diseased vertebral bone cement reinforcement in treating senile thoracolumbar fractures

作　　者：李建辉 詹红建 姜春晓 郑利明 LI Jianhui;ZHAN Hongjian;JIANG Chunxiao;ZHENG Liming(Department of Orthopedics,People’s Hospital of Longyou County,Quzhou,Zhejiang 324400,China)

机构地区：[1]龙游县人民医院骨科,浙江衢州324400

出　　处：《重庆医学》2024年第S01期46-49,共4页Chongqing Medical Journal

摘　　要：目的探讨后路椎弓根钉内固定结合病椎骨水泥强化治疗老年性胸腰椎骨折的近远期疗效。方法选取2018年2月至2021年2月该院收治的60例老年性胸腰椎骨折患者为研究对象,分为对照组(30例)和联合组(30例)。对照组给予后路椎弓根钉内固定术治疗,联合组给予后路椎弓根钉内固定结合病椎骨水泥强化治疗。比较两组疼痛情况[视觉模拟评分法(VAS)],恢复情况(住院时间、骨折愈合时间、下床活动时间及疼痛缓解时间),腰椎功能[Oswestry功能障碍指数(ODI)],Cobb角、椎体前缘高度压缩率,骨代谢指标[Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、骨特异性碱性磷酸酶(BAP)]及并发症发生情况。结果术前、术后3个月、12个月两组VAS评分、ODI评分、Cobb角、椎体前缘高度压缩率、血清β-CTx、BAP水平逐渐降低(P<0.05),且术后3个月、12个月联合组明显低于对照组(P<0.05);联合组住院时间、骨折愈合时间、下床活动时间及疼痛缓解时间均明显短于对照组(P<0.05);两组螺钉松动、椎体塌陷及骨水泥渗漏等并发症发生率比较无明显差异(P>0.05)。结论后路椎弓根钉内固定结合病椎骨水泥强化治疗老年性胸腰椎骨折可有效减轻患者疼痛,促进术后恢复,提高腰椎功能,改善骨代谢。Objective To investigate the short-term and long-term effects of posterior pedicle screw fixation combined with diseased vertebral bone cement reinforcement in treating senile thoracolumbar fractures.Methods Sixty patients with senile thoracolumbar fracture admitted to this hospital from February 2018 to February 2021 were selected as the study objects and randomly grouped into the control group(30 cases)and the combined group(30 cases).The patients in the control group were treated with posterior pedicle screw internal fixation,and the patients in the combined group were treated with posterior pedicle screw internal fixation combined with diseased vertebral bone cement reinforcement.The pain status[visual analogue scale(VAS)],recovery status(hospitalization time,fracture healing time,ambulation time and pain relief time),lumbar spine function[Oswestry Disability Index(ODI)],Cobb angle,vertebral body anterior high compression rate,bone metabolism index[typeⅠcollagen carboxyl-terminal peptideβspecial sequence(β-CTx),bone-specific alkaline phosphatase(BAP)]and complications were compared between the two groups.Results The VAS score,ODI score,Cobb angle,anterior vertebral body compression ratio,serumβ-CTx and BAP levels decreased gradually in the two groups before operation,3 months and 12 months after operation(P<0.05),the combined group were significantly lower than the control group 3 months and 12 months after operation(P<0.05);the hospital stay,fracture healing time,ambulation time and pain relief time in the combined group were significantly shorter than those in the control group(P<0.05);there was no significant difference in the incidences of complications such as screw loosening,vertebral body collapse and bone cement leakage between the two groups(P>0.05).Conclusion Posterior pedicle screw fixation combined with diseased vertebral bone cement reinforcement in treating senile thoracolumbar fractures can effectively relieve pain,promote postoperative recovery,improve lumbar spine function,and improve bo

关 键 词：老年性胸腰椎骨折 骨水泥 后路椎弓根钉内固定 疗效 

分 类 号：R687.3[医药卫生—骨科学]