手法复位配合经皮椎体成形术治疗骨质疏松性胸腰段脊柱压缩骨折的临床研究  

Clinical study on manual reduction combined with percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar spinal compression fractures

作　　者：周海涛 刘沛 Zhou Haitao;Liu Pei(Department of Orthopedics,Beijing Longfu Hospital,Beijing 100010,China;Department of Knee Surgery,Luoyang Orthopedic Hospital(Henan Orthopedic Hospital),Zhengzhou 450002,China)

机构地区：[1]北京市隆福医院骨科,北京100010 [2]洛阳正骨医院(河南省骨科医院)膝关节外科,郑州450002

出　　处：《中国医师进修杂志》2025年第3期221-226,共6页Chinese Journal of Postgraduates of Medicine

基　　金：河南省中医药科学研究专项课题(2022ZY1130)。

摘　　要：目的观察对骨质疏松性胸腰段脊柱压缩骨折患者采取手法复位配合经皮椎体成形术(PVP)治疗的临床效果。方法前瞻性选择洛阳正骨医院2020年1月至2022年12月收治的骨质疏松性胸腰段脊柱压缩骨折患者124例,以随机数字表法分为治疗组与对照组,各62例,对照组实施PVP治疗,治疗组在手法复位后实施PVP。比较两组治疗效果、手术相关指标、疼痛程度、椎体高度及Cobb角。结果治疗组总优良率高于对照组[93.55%(58/62)比80.65%(50/62)],差异有统计学意义(P<0.05)。治疗组术中透视时间、单个椎体手术时间均短于对照组[(54.87±9.42)s比(76.32±10.06)s、(29.51±7.89)min比(38.59±8.35)min],差异有统计学意义(P<0.01);两组骨水泥弥散系数比较差异无统计学意义(P>0.05);术后1、3和7 d治疗组视觉模拟评分(VAS)均低于对照组[(4.43±1.06)分比(5.31±1.14)分、(3.16±0.62)分比(4.25±0.77)分、(1.28±0.35)分比(2.14±0.49)分],差异有统计学意义(P<0.01);治疗组总并发症发生率低于对照组[3.22%(2/62)比12.90%(8/62)],差异有统计学意义(P<0.05);治疗组术后3和6个月椎体高度高于对照组[(23.79±2.16)mm比(21.34±2.23)mm、(23.60±2.04)mm比(21.22±2.16)mm],治疗组术后3和6个月Cobb角低于对照组[(19.24±2.68)°比(21.76±3.00)°、(14.43±2.51)°比(17.79±2.64)°],差异有统计学意义(P<0.01)。结论骨质疏松性胸腰段脊柱压缩骨折患者采用手法复位配合PVP治疗有利于缩短术中透视时间及手术时间,减轻疼痛,恢复椎体高度,改善Cobb角,恢复椎体功能,增强骨密度,值得推广实施。Objective To observe the clinical efficacy of manual reduction combined with percutaneous vertebroplasty(PVP)in the treatment of osteoporotic thoracolumbar spinal compression fractures through a prospective study.Methods A total of 124 patients with osteoporotic thoracolumbar compression fractures admitted to Beijing Luoyang Orthopedic Hospital from January 2020 to December 2022 were prospectively selected and randomly divided into a treatment group and a control group,with 62 patients in each group.The control group underwent PVP surgery,while the treatment group underwent PVP surgery after manual reduction.Compare the treatment efficacy,surgical related indicators,pain level,vertebral height and Cobb angle between two groups.Results The total effective rate of the treatment group was higher than that of the control group:93.55%(58/62)vs.80.65%(50/62),and the difference was statistically significant(P<0.05).The intraoperative fluoroscopy time and single vertebral body surgery time in the treatment group were shorter than those in the control group:(54.87±9.42)s vs.(76.32±10.06)s,(29.51±7.89)min vs.(38.59±8.35)min,with statistical significance(P<0.01);there was no statistically significant difference in the diffusion coefficient between the two groups of bone cement(P>0.05).On postoperative 1,3,and 7 d,the visual analog score(VAS)of the treatment group were lower than those of the control group:(4.43±1.06)points vs.(5.31±1.14)points,(3.16±0.62)points vs.(4.25±0.77)points,(1.28±0.35)points vs.(2.14±0.49)points,with statistical significance(P<0.01).The incidence of complications in the treatment group was lower than that in the control group:3.22%(2/62)vs.12.90%(8/62),and the difference was statistically significant(P<0.05).The vertebral height of the treatment group was higher than that of the control group at 3 and 6 months after surgery:(23.79±2.16)mm vs.(21.34±2.23)mm,(23.60±2.04)mm vs.(21.22±2.16)mm,and the Cobb angle of the treatment group was lower than that of the control group at 3 and 6 mont

关 键 词：骨质疏松性骨折 手法复位 经皮椎体成形术 胸腰段脊柱压缩骨折 椎体高度 

分 类 号：R68[医药卫生—骨科学]