摘要
目的探讨体位过伸复位联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床效果。方法 2008年7月～2011年10月对32例老年骨质疏松性椎体骨折过伸复位前后采用C形臂X线机透视,然后行经皮经椎弓根通道球囊扩张注入骨水泥椎体后凸成形术。术前及术后24 h分别采用疼痛视觉模拟系统(VAS)进行评分,对复位前、复位后及术后椎体前缘和中缘高度丢失率、Cobb角进行比较。结果术后32例胸背部疼痛基本消失,未发生神经系统损伤及肺拴塞等并发症。术前VAS评分(7.38±1.02)分显著高于术后VAS评分(1.25±0.24)分(t=2.652,P=0.003)。过伸复位前椎体前缘高度丢失率(41.36±9.27)%、中缘高度丢失率(21.52±3.08)%及Cobb角(24.31±3.59)°与术后即刻比较有显著性差异[(22.18±4.17)%,q=15.680,P<0.05;(11.79±2.03)%,q=19.548,P<0.05;(10.43±2.29)°,q=25.762,P<0.05]。32例术后随访6～12个月,平均9.2月,腰背痛症状均无复发,术后患者疼痛较术前明显缓解。结论过伸复位可有效恢复伤椎高度,改善椎体畸形程度,联合球囊扩张椎体后凸成形术可显著提高伤椎前中柱高度,纠正后凸畸形角度,具有损伤小、疗效好的优点。
Objective To explore the efficacy of percutaneous kyphoplasty（PKP） and hyperextension reduction for osteoporotic vertebral compression fractures（OVCF） in elderly patients.Methods From July 2008 to October 2011,32 OVCF patients were treated with PKP combined with hyperextension reduction in our hospital.Hyperextension reduction was done under the guidance by C-arm X-ray,and then PKP was carried out by injecting polymethylmethacrylate（PMMA）.The pain score were made according to VAS pre-and 24-hour postoperatively,and the vertebral heights,Cobb angle of pre-and post-reduction and postoperation were measured.Results In all the patients,back pain was evidently relieved within 24 hours postoperation,no neurological injury nor pulmonary embolism occurred.Preoperative VAS was significantly higher than the postoperative one [7.38±1.02 vs.1.25±0.24,t=2.652,P=0.003].The rate of height loss of the anterior vertebral edge was（41.36±9.27）%,and that of the middle vertebral edge was（21.52±3.08）%,which were both significantly different from the preoperative measurements [（22.18±4.17）%,q=15.680,P＆lt;0.05;（11.79±2.03）%,q=19.548,P＆lt;0.05].The Cobb angle was significantly increased after the procedure [（24.31±3.59）° vs.（10.43±2.29）°,q=25.762,P＆lt;0.05].The patients were followed up for a mean of 9.2 months（ranged from 6 to 12 months）,during which no recurrent back pain was reported,all the patients were remarkably relived.Conclusions Hyperextension reduction effectively restore the vertebral height and improve vertebral malformation.Combined with PKP,it can significantly increase the middle edge of the vertebral height and correct the Cobb angle with a minimal invasion.
出处
《中国微创外科杂志》
CSCD
2013年第4期336-338,342,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
过伸复位
骨质疏松性椎体压缩骨折
经皮椎体后凸成形术
Hyperextension reduction
Osteoporotic vertebral compression fractures（OVCF）
Percutaneous kyphoplasty
