Objective To compare the efficacy of adjacent double segment fixation with inner-vertebral bone graft and percutaneous kyphoplasty for treatment of osteoporotic thoralumbar vertebral fractures. Methods Eighteen patients with osteoporotic vertebral compression fractures (OVCFs) treated with adjacent double segment fixation and inner-vertebral bone graft and 18 patients treated with percutaneous kyphoplasty were retrospectively analyzed. The change of vertebral height and the healing of diseased vertebra were compared. All patients were followed up. Visual analogue scale (VAS) was performed in all patients. The changes of image and symptom were observed after the treatment. Results All the 36 patients were followed up for 8-26 months (16 months in average). Indexes of patients in 1 week after the surgery and at the last follow-up improved significantly compared with the results before the surgery ( P < 0. 05 ). The comparison of results between 1 week after the surgery and the last follow-up showed no significant difference ( P > 0. 05 ) . All the diseased vertebra healed well without the eggshell phenomenon. The spinal deformity was corrected. Conclusion Adjacent double segment fixation with inner-vertebral bone graft and percutaneous kyphoplasty for the treatment of osteoporotic thoralumbar vertebral fractures possess respective indications, prohibitions, advantages, and disadvantages. Their efficacies show no significant difference.%目的 比较邻近双椎联合内固定椎体内植骨和经皮穿刺椎体成型治疗骨质疏松性胸腰椎骨折的疗效.方法 回顾分析采用邻近双椎联合内固定椎体内植骨和经皮穿刺椎体成型治疗骨质疏松性胸腰椎骨折各18例,比较手术后椎体高度变化,病椎愈合情况,并随访观察.对患者进行疼痛视觉模拟评分(VAS),对比影像学改变和患者自觉症状改变.结果 36例患者均获得随访,时间是8～26个月,平均16个月.术前、术后1w及末次随访,各项指标均较术前有显著改善,差异有统计学意义(P＜0.05).术后lw和末次随访比较差异无统计学意义(P＞0.05).责任椎体均示愈合良好,无蛋壳现象发生.脊柱畸形得到矫正.结论 邻近双椎联合内固定椎体内植骨和经皮穿刺椎体成型治疗骨质疏松性胸腰椎骨折有各自适应症、禁忌症和优缺点,在各自手术适应症下安全手术,其疗效并无显著性差异.
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