摘要
[目的]评估骨水泥强化椎弓根螺钉固定结合椎体后凸成形术percutaneous kyphoplasty，PKP）治疗骨质疏松性胸腰椎爆裂骨折的临床疗效。[方法]收集本院2011年1月至2012年12月采用骨水泥强化椎弓根螺钉固定结合PKP治疗的31例无神经损伤的骨质疏松性胸腰椎爆裂骨折患者，观测术前、术后1周及术后1年伤椎前后缘压缩率改变、后凸Cobb角、视觉模拟评分（visual analogue scale，VAS）及术后并发症，评估手术效果。[结果]术前椎体前、后缘压缩率分别为（495±6.1）％和（16.7±3.2）％，术后1年椎体前后缘压缩率分别为（9.1±1.3）％和（1.2±0.9）%，Cobb角由术前平均（25.7±4.5）°矫正至术后（3.3±2.1）°，平均矫正19.8。，VAS评分由术前平均（7.2±0.5）分降为术后（1.9±O.6）分，各项指标术后与术前比较差异均有统计学意义（P〈0.05）。术后随访12-24个月，无1例发生手术并发症。[结论]骨水泥强化椎弓根螺钉固定结合PKP治疗骨质疏松性胸腰椎爆裂骨折，能有效恢复脊柱矢状序列，同时也能较好地维持伤椎的高度和强度，避免术后椎体塌陷，有助于早期康复，减少并发症。
[Objective] To assess the efficacy of bone cement augmentation of pedicle screw fixation combined with kyphoplasty for osteoporotic thoracolumbar burst fractures. [Methods] Thirty-one cases of neurologically intact osteoporotic thoracolumbar burst fractures treated by bone cement augmentation of pedicle screw fixation combined with kyphoplasty between January 2011 and December 2012 were included in this study. Then analyze the front and back edges height of the injured vertebra, kyphosis Cobb＇s angle, visual analogue scale（VAS） and complications. [Results] Patients were followed up for 12 to 24 months（mean 18.2 months）, there was no complication. All patients recovered satisying, front and back edges of the compression ratio was （49.5±6.1）% and （16.7±3.2）%, respectively, after l-year follow-up, front and back edges of vertebral compression rates were （9.1±1.3）% and （1.2±0.9）%, the correction of Cobb＇s angle from （25.7±4.5）° to （3.3±2.1）°, the average correction angle was 19.8°; and VAS score decreased from （7.2±0.5） to （1.9±0.6）. There were significantly statistical differences（P〈0.05） in all indexes between pre-operation and post-operation. [Conclusion] Bone cement augmentation of pedicle screw fixation combined with kyphoplasty for osteoporotic thoracolumbar burst fi＇actures, can effectively restore spinal sagittal alignment, maintain the height and strength for injured vertebral, avoid vertebral collapse and reduce complications.
出处
《浙江中医药大学学报》
CAS
2014年第8期984-987,共4页
Journal of Zhejiang Chinese Medical University
