经椎弓根伤椎椎体内植骨联合短节段内固定治疗单节段骨质疏松性脊柱骨折的临床效果  

Clinical Effect of Bone Grafting in Injured Vertebral Body via Vertebral Pedicle Combined with Short Segment Internal Fixation in the Treatment of Single Segment Osteoporotic Spinal Fracture

作　　者：仓定伟 CANG Dingwei(Department of Orthopedics,Yancheng NO.1 People's Hospital,Yancheng 224000,China)

机构地区：[1]盐城市第一人民医院骨科,江苏盐城224000

出　　处：《中国医学创新》2024年第29期15-19,共5页Medical Innovation of China

摘　　要：目的:探讨单节段骨质疏松性脊柱骨折应用短节段内固定联合经椎弓根伤椎椎体内植骨治疗的效果。方法:将2020年1月—2023年1月盐城市第一人民医院收治的82例单节段骨质疏松性脊柱骨折患者按随机数字表法分为对照组(n=41,采用短节段内固定治疗)、研究组(n=41,短节段内固定联合经椎弓根伤椎椎体内植骨治疗)。对两组脊柱功能、Cobb角、椎体高度丢失量、疼痛程度、日常生活能力及内固定物松动断裂情况进行对比。结果:两组术后3个月Prolo腰椎功能评定表(Prolo)评分、日常生活能力(activity of daily living,ADL)评分与术前相比均升高,且研究组均更高,差异均有统计学意义(P<0.05)。两组术后3个月Oswestry功能障碍指数(Oswestry disability index,ODI)、视觉模拟评分法(visual analogue scale,VAS)评分及术后3个月、1年的椎体高度丢失量、Cobb角与术前相比均降低,且研究组均更低,差异均有统计学意义(P<0.05)。研究组内固定物松动断裂发生率(2.44%)低于对照组(19.51%),差异有统计学意义(P<0.05)。结论:单节段骨质疏松性脊柱骨折采取短节段内固定联合经椎弓根伤椎椎体内植骨治疗可有效缓解疼痛情况,促进脊柱功能恢复,降低内固定物松动断裂风险,有利于改善患者日常生活能力。Objective:To explore the effect of bone grafting in injured vertebral body via vertebral pedicle combined with short segment internal fixation in the treatment of single segment osteoporotic spinal fracture.Method:A total of 82 patients with single segment osteoporotic spinal fracture admitted to Yancheng NO.1 People's Hospital from January 2020 to January 2023 were divided into control group(n=41,treated with short segment internal fixation)and study group(n=41,treated with short segment internal fixation combined with bone grafting in injured vertebral body via vertebral pedicle)according to random number table method.The spinal function,Cobb angle,vertebral height loss,pain degree,ability of daily living and the loosening and rupture of internal fixator were compared between the two groups.Result:Prolo lumbar function rating scale(Prolo)scores and activity of daily living(ADL)scores were higher in both groups 3 months after surgery than those before surgery,and those were higher in the study group,the differences were statistically significant(P<0.05).3 months after surgery,Oswestry disability index(ODI),visual analogue scale(VAS)scores,3 months and 1 year after surgery of vertebral height loss and Cobb angle were decreased in both groups,and those were higher in the study group,the differences were statistically significant(P<0.05).The incidence of loosening and rupture of internal fixator in study group(2.44%)was lower than that in control group(19.51%),the difference was statistically significant(P<0.05).Conclusion:Short segment internal fixation combined with bone grafting in injured vertebral body via vertebral pedicle for single segment osteoporotic spinal fracture can effectively alleviate pain,promote spinal function recovery,reduce the risk of loosening and rupture of internal fixator,and help improve patients'daily living ability.

关 键 词：骨质疏松性脊柱骨折 短节段内固定术 经椎弓根伤椎椎体内植骨 脊柱功能 日常生活能力 

分 类 号：R687.3[医药卫生—骨科学]