手法复位联合经皮椎体成形术对老年骨质疏松性椎体骨折患者椎体高度及疼痛的影响

摘要

目的 探讨手法复位联合经皮椎体成形术对老年骨质疏松椎体压缩骨折患者椎体高度及疼痛的影响.方法将2013年7月-2016年4月于本院骨科就诊的严重椎体骨折老年患者195例随机分为研究组98例和对照组97例,两组均行经皮椎体成形术治疗.研究组在手术治疗前先行手法复位,观察并记录两组手术前后椎体高度及疼痛程度的改善情况.结果术后1周,研究组的伤椎前缘、中线、后缘高度分别为(23.97±l. 27)mm、(26.61 ± 1.37) mm、(28.17 ±0.75) mm, 对照组分别为(22.33 ±1.39) mm、(24.83 ± 1.08) mm、(27.34 ±1.52) mm,研究组的伤椎高度均高于对照组(P均＜ 0.05).测量所有患者术前、术后1周、术后3个月及术后12个月的VAS值,研究组的VAS评分分别为(6.28 ±0.56)、(2.53 ±0.33)、(1.34 ±0.23)、(l. 09±0.18),对照组的VAS评分分别为(6.34 ± 0.58)、(3.18 ±0.49)、(2.72 ±0.40)、(1.87 ± 0.25);术前两组患者的VAS评分无统计学差异(P均＞ 0.05),术后两组患者的VAS均有大幅度的降低,且研究组的VAS评分显著低于对照组(P均＜ 0.05).结论手法复位结合椎体成形术治疗老年严重椎体骨折有显著的临床效果.%Objective To investigate the influences of manual reduction combined with percutaneous vertebroplasty on vertebral body height and pain in vertebral fracture senile osteoporosis patients with vertebral fracture. Methods Totally 195 senile osteoporosis patients with severe vertebral fracture admitted to our department from July 2013 to April 2016 were randomly divided into two groups with 98 cases in research group and 97 cases in control group, and both of the two groups underwent percutaneous vertebroplasty (PVP). Before surgery, the research group were treated with manual reduction, and the improvement of vertebral height and pain level of the two groups were recorded. Results One week after surgery, the heights of anterior, midline and posterior edge of the injured vertebra in the research group were higher than those of control group [(23.97土1.27) mm vs (22.33±1.39) mm, (26.61±1.37) mm vs (24.83±1.08) mm, (24.17±0.75) mm vs (27.34 ± 1.52) mm, P ＜ 0.05, respectively]. VAS scores of all the patients before operation, at 1 weeks, 3 months and 12 months after operation in research group and the control group were (6.28土0.56) vs (6.34 ± 0.58), (2.53 ±0.33) vs (3.18±0.49), (1.34±0.23) vs (2.72 ± 0.40), (1.09 ±0.18) vs (1.87 ±0.25) (All P ＞ 0.05). After operation, VAS scores of both of the two groups decreased significantly, and the research group was significantly lower than that of the control group (P ＜ 0.05). Conclusion The manual reduction combined with percutaneous vertebroplasty has obvious clinical effect in senile osteoporotic vertebral fracture.