术中体外手法复位在椎体成型治疗椎体压缩骨折中的疗效观察  

Observation on the Curative Effect of Intraoperative Manual Reduction in Vitro in the Treatment of Vertebral Compression Fractures with Percutaneous Vertebroplasty

作　　者：刘智[1] 郭树章 王铜浩[1] 田永刚[1] 韩立强[1] 吴凯楠 LIU Zhi;GUO Shuzhang;WANG Tonghao;TIAN Yonggang;HAN Liqiang;WU Kainan(Department of Orthopaedics,the Third Central Hospital of Tianjin/Tianjin Key Laboratory of Extracorporeal Life Supportfor Critical Diseases/Artificial Cell Engineering Technology Research Center/Tianjin Instituteof Hepatobiliary Disease,Tianjin 300381,China)

机构地区：[1]天津市第三中心医院骨科/天津市重症疾病体外生命支持重点实验室/天津市人工细胞工程技术研究中心/天津市肝胆疾病研究所,天津300381

出　　处：《医学信息》2025年第9期117-120,共4页Journal of Medical Information

摘　　要：目的探讨椎体成型术治疗老年骨质疏松性椎体压缩骨折(OVCF)时,采用体位复位结合手术中注射骨水泥过程中体外手法复位的治疗效果。方法收集2022年6月-2023年5月天津市第三中心医院老年(≥60岁)OVCF行经皮椎体成型术治疗时采用术中体外手法复位的病例资料,共31例,随访1个月,测量术前、术后椎体压缩程度、Cobb角,记录患者术前、术后疼痛视觉模拟评分(VAS),观察该方法的疗效。结果术前、术后椎体压缩程度及伤椎Cobb角、VAS评分比较,差异有统计学意义(P<0.05);所有病例无神经损伤及伤口感染、血肿发生。有骨水泥渗漏5例,其中椎间盘渗漏3例,前方渗漏1例,侧方渗漏1例,无椎管内渗漏病例。术中骨水泥注射过程中一过性低血压1例,应用地塞米松2分钟后恢复。结论体位复位后,在手术中骨水泥推注时另外施加手法复位力,存在持续的复位力,可以获得更加满意的复位效果,降低后凸的残留程度,临床疗效佳。Objective To discuss the treatment effect of posture hypertension reduction combined with manual reduction during the injection of bone cement in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures in the elderly.Methods The clinical data of 31 elderly patients(≥60 years old)with OVCF who underwent percutaneous vertebroplasty in the Third Central Hospital of Tianjin from June 2022 to May 2023 were collected.A total of 31 patients were followed up for 1 month.The degree of vertebral compression and Cobb angle before and after operation were measured,and the visual analogue scale(VAS)of pain before and after operation was recorded to observe the efficacy of this method.Results There were significant differences in vertebral compression degree,Cobb angle and VAS score before and after operation(P<0.05).No nerve injury,wound infection and hematoma occurred in all cases.There were 5 cases of bone cement leakage,including 3 cases of intervertebral disc leakage,1 case of anterior leakage,1 case of lateral leakage,and no case of intraspinal leakage.Transient hypotension occurred in 1 case during intraoperative bone cement injection,and recovered after 2 minutes of dexamethasone application.Conclusion After posture hyperextension reduction,the application of additional manual reduction force in the course of bone cement injection provides a continuous reduction force,which can achieve more satisfactory reduction results,reduce the degree of residual kyphosis,and has good clinical efficacy.

关 键 词：椎体成型 椎体压缩骨折 复位 椎体高度 

分 类 号：R687.3[医药卫生—骨科学]