复位床托闭合复位结合经皮椎体成形术（PVP）治疗骨质疏松性胸腰椎压缩骨折

摘要

To explore the therapeutic effects of the Reposition Support Mattress (RSM)closed reduction in percutaneous vertebroplasty ( PVP) for the treatment of the thoracic and lumbar vertebrae compression fractures .Methods:Painless patients were trea-ted with closed reduction under C -arm x-ray monitoring by supining on the Reposition Support Mattress manual controled , and then PVP was performed on the fractured vertebra .The results of pre-operation, 3 days after and 3monthes after the operation were quantita-tively evaluated according to the concept of VAS、signs and movements 、estimated vertebral height loss and vertebrotic angle of the verte-bral compression fracture .Results:Operations on the 38 cases of 44 vertebraes are curative effect .Bone cement leakage happened in two cases including anterial and lateral without posterial .Pain scores,vertebral heightsand Cobb angle improved significantly (P<0.05)after the surgery.Conclusion:The Reposition Support Mattress (RSM) closed reduction in PVP was effective in the treatment of thoracic and lumbar vertebral compression fractures .%目的：探索复位床托闭合复位结合经皮椎体成形术（ percutaneous vertebroplasty， PVP）治疗骨质疏松性胸腰椎压缩骨折的疗效。方法：患者止痛后仰卧于自制复位床托上，手控升高床托，C臂X光机监视下复位，再结合PVP治疗。在术前、术后3天、术后3个月随访时进行疼痛视觉类比评分（ VAS）、体征、活动能力评分、计算治疗前后椎体前缘高度丢失率和脊柱后凸畸形Cobb角。结果：38例44个椎体均收到满意疗效，骨水泥向椎体前方、侧方渗漏各2例，无椎体后方椎管内渗漏。 VAS评分由术前8．23±1．24降低至2．25±1．14，椎体前缘高度丢失率由术前28．74±4．46改善至14．04±3．36，Cobb角由术前20．4°±7．3°改善至11．4°±5．2°。结论：复位床托闭合复位结合PVP能有效治疗骨质疏松性胸腰椎压缩骨折，值得临床推广。