俯卧位过伸法手法复位联合经皮椎体成形术治疗老年稳定性胸腰椎骨折的临床效果  

Clinical observation on the treatment of senile osteoporotic thoracolumbar fracture by manual reduction of prone hyperextension combined with percutaneous vertebroplasty

作　　者：夏志宏[1] 陈建秋[1] 于伟霞 蔡晓辉[1] XIA Zhi-hong;CHEN Jian-qiu;YU Wei-xia(Shanghai Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China)

机构地区：[1]上海市嘉定区中医医院,上海201800 [2]上海市嘉定区精神卫生中心,上海201800

出　　处：《中国中西医结合外科杂志》2025年第2期218-222,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：嘉定区卫健委面上项目(2023-KY-06)。

摘　　要：目的:探究俯卧位过伸法手法复位结合经皮椎体成形术(PVP)对老年稳定性胸腰椎骨折患者的临床疗效。方法:纳入61例老年稳定性胸腰椎骨折患者,随机分为对照组(n=30)和观察组(n=31),对照组只接受PVP术,观察组在俯卧位过伸法手法复位的基础上结合PVP术。比较两组患者胸腰椎愈合效果、疼痛程度、胸腰椎功能及整体疗效。结果:治疗后,观察组总有效率大于对照组(90.32%vs 80.00%,P<0.05);与对照组相比,观察组手术时间(36.78±8.02 vs 42.21±9.10)、术后疼痛缓解时间(8.12±0.60 vs 9.98±0.83)、骨折愈合时间(70.36±10.47 vs 82.13±9.56)和骨水泥渗漏比例(3.23%vs 10.00%)均显著降低(P<0.05);观察组伤椎前缘高度显著升高(26.07±6.92 vs 25.14±8.60,P<0.05),伤椎楔变角(9.02±2.11 vs 9.85±3.26,P<0.05)和后凸Cobb角(8.96±3.47 vs 10.08±4.39,P<0.05)显著降低;两组患者的ODI评分(5.57±1.50 vs 8.32±1.36)、VAS评分(3.05±1.41 vs 3.82±1.74)均降低,JOA评分(22.25±3.37 vs 19.41±2.64)均升高,且观察组的改善程度更佳(P<0.05)。结论:俯卧位过伸法手法复位结合PVP可促进老年稳定性胸腰椎骨折患者的骨愈合,提高临床疗效。Objective To investigate the effects of manual reduction of prone hyperextension(MRPH)combined with percutaneous vertebroplasty(PVP)on the clinical efficacy and anatomical imaging indexes of elderly patients with stable thoracolumbar fracture.Methods A total of 61 elderly stable thoracolumbar fracture patients were included and randomly divided into two groups:the control group(n=30)and the observation group(n=31).The control group received only PVP treatment,while the observation group received MRPH combined with PVP.Clinical efficacy,thoracolumbar healing effect,pain levels,and thoracolumbar function were compared between the two groups.Results After treatment,the total effective rate of observation group was higher than that of control group(90.32%vs 80.00%,P<0.05).Compared with the control group,the operation time(36.78±8.02 vs 42.21±9.10),the postoperative pain relief time(8.12±0.60 vs 9.98±0.83),the fracture healing time(70.36±10.47 vs 82.13±9.56)and the proportion of bone cement leakage(3.23%vs 10.00%)in the observation group were significantly reduced(P<0.05).In the observation group,the height of anterior vertebra was significantly increased(26.07±6.92 vs 25.14±8.60,P<0.05),the Angle of wedge variation(9.02±2.11 vs 9.85±3.26)and the kyphotic Cobb angle(8.96±3.47 vs 10.08±4.39)significantly decreased(P<0.05);ODI scores(5.57±1.50 vs 8.32±1.36)and VAS scores(3.05±1.41 vs 3.82±1.74)were decreased in both groups,while JOA scores(22.25±3.37 vs 19.41±2.64)were increased.The improvement degree of observation group was better(P<0.05).Conclusion MRPH combined with PVP effectively alleviates clinical symptoms among elderly ossification of the thoracic ligamentum flavum patients while promoting bone healing and improving bone mineral density as well as bone metabolism status.Consequently,MRPH combined with PVP may represent a novel therapeutic strategy for elderly patients with stable thoracolumbar fracture.

关 键 词：俯卧位过伸法手法复位 经皮椎体成形术 老年稳定性胸腰椎骨折 骨愈合 

分 类 号：R683.2[医药卫生—骨科学]