过伸复位联合单侧入路椎体成形术治疗骨质疏松性胸腰椎体压缩骨折的疗效评价

摘要

目的 观察过伸复位及单侧入路椎体成形术联合应用在骨质疏松性胸腰椎体压缩骨折治疗中的效果.方法 收集2012年11月-2016年3月在邵阳学院附属第一医院骨科收治新鲜骨质疏松性椎体压缩骨折患者80例,按治疗方法不同分为单纯手术组和联合组,其中接受单侧入路椎体成形术治疗者为单纯手术组,共38例;以接受过伸复位和单侧入路椎体成形术治疗者为联合组,共42例.对2组术中及术后恢复情况进行评价.结果 与术前比较,术后24周内,2组VAS评分及Cobb角均呈下降趋势(P <0.01);术前2组VAS评分及Cobb角比较,差异无统计学意义(P >0.05),术后12、24周,联合组VAS评分及Cobb角低于单纯手术组,差异具有统计学意义(P <0.01).与治疗前比较,2组治疗后椎体前缘高度均呈上升趋势(P <0.01),联合组在术后椎体前缘高度水平明显优于单纯手术组,差异有统计学意义(P <0.01).在24周的随访期间内,联合组患者术后并发症的发生率较单纯手术组患者低,差异具有统计学意义(P <0.05).结论 相对于单纯单侧入路椎体成形术治疗,术中给予过伸复位可有效地提高骨质疏松性胸腰椎体压缩骨折的术后恢复效果.%Objective To observe the effect of combined reduction and unilateral approach vertebroplasty in the treatment of osteoporotic thoracic lumbar vertebral compression fractures.Methods From November 2012 to March 2016 in the Department of Orthopedics of the First Affiliated Hospital of Shaoyang University,80 cases of fresh osteoporotic vertebral compression fractures patients were enrolled,according to the different treatment methods,they were divided into surgery group and combined group,surgery group received a unilateral approach vertebroplasty treatment(38 cases);combined group accept hyperextension and unilateral approach vertebral body angioplasty treatment(42 cases).The intraoperative and postoperative recovery of the 2 groups were evaluated.Results Compared with pre-operation,after 24 weeks postoperatively,2 groups of VAS score and Cobb angle decreased(P<0.01);the 2 groups pre-operative VAS score and Cobb angle''s difference was not statistically significant(P>0.05),12 and 24 weeks after operation,combined group''s VAS score and Cobb angle were lower than the operation group.The difference was statistically significant(P<0.01).Compared with before treatment,the height of the leading edge of the vertebral body showed an upward trend(P<0.01)after the treatment,and the level of the leading edge of the vertebral body in the joint group was significantly better than that of the only surgery group,the difference was statistically significant(P<0.01);During the 24 week follow-up period,the incidence of postoperative complications in the combined group was lower than that in the only surgery group,and the difference was statistically significant(P<0.05).Conclusion Compared with the simple unilateral approach vertebroplasty,the extension reduction during the operation can effectively improve the postoperative recovery of osteoporotic vertebral compression fractures.