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经横突上嵴椎弓根螺钉植入术联合椎体成形术治疗老年骨质疏松性胸椎骨折的可行性研究 被引量:3

Study on the feasibility of pedicle screw implantation through transverse ridge combined with vertebral plasty in the treatment of thoracic vertebral fracture due to senile osteoporosis
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摘要 目的:探讨对老年骨质疏松性胸椎骨折患者行横突上嵴胸椎椎弓根螺钉植入术联合椎体成形术治疗的效果。方法对池州市人民医院骨一科2011年2月~2015年2月收治的38例老年骨质疏松性胸椎骨折患者进行分析,并采用随机数字表法将其分为对照组和观察组,对照组实施单纯胸椎椎弓根螺钉植入术治疗,观察组实施横突上嵴胸椎椎弓根螺钉植入术联合椎体成形术治疗,并观察两组患者的手术情况及手术效果。结果观察组手术时间[(78.39±5.68)min]明显长于对照组[(48.54±5.27)min],卧床时间[(16.42±3.67)d]明显短于对照组[(42.36±4.05)d],差异均有统计学意义(P〈0.05),而两组术中出血量比较差异无统计学意义(P跃0.05);两组椎体前缘高度、椎体后缘高度均较术前显著提高(P〈0.05),而Cobb角较术前明显降低(P〈0.05),其中观察组改善情况优于对照组(P〈0.05);两组患者术后VAS评分均明显降低(P〈0.05),其中观察组降低程度明显高于对照组(P〈0.05);对照组治疗后有2例再骨折现象;观察组治疗后有2例骨水泥椎间盘外漏现象、1例肋间神经痛觉敏感,两组比较差异无统计学意义(P跃0.05)。结论对老年骨质疏松性胸椎骨折患者实施横突上嵴胸椎椎弓根螺钉植入术联合椎体成形术治疗效果显著,可行性和安全性高,值得临床推广使用。 Objective To discuss the effect of thoracic pedicle screw implantation through transverse ridge combined with vertebral plasty for patients with thoracic vertebral fracture due to senile osteoporosis. Methods 38 cases of pa-tients with thoracic vertebral fracture due to senile osteoporosis admitted to the First Department of Orthopaedics of the People's Hospital of Chizhou from February 2011 to February 2015 were analyzed and divided into control group and observation group according to random number table, the control group was only given thoracic pedicle screw implanta-tion, while the observation group was given thoracic pedicle screw implantation through transverse ridge combined with vertebral plasty. Operation conditions and results were observed. Results The operative time of the observation group [(78.39±5.68) min] was significantly longer than (48.54±5.27) min of the control group; the time in bed [(16.42±3.67) d] was significantly shorter than that of control group [(42.36±4.05) d], the differences were all statistically significant (P〈0.05); the blood loss between the two groups had no statistically significant difference (P〉0.05); the vertebral height, the height of the trailing edge in the two groups were all improved compared with before operation (P〈 0.05), but the Cobb angle was significantly lower than before operation (P〈0.05), and the improvement of observation group was bet-ter than the control group (P 〈 0.05); after surgery, VAS scores of the two groups were significantly lower (P 〈0.05), and the decreased extent of the observation group was significantly higher than that of control group (P〈0.05); 2 patients of the control group had another frac-ture phenomenon; in the observation group, there were 2 patients of bone cement disc leakage phenomenon, one case of intercostal neuralgia sensitive, there was no statistically significant difference (P〉0.05). Conclusion The effect of thoracic pedicle screw implantation through transverse ridge combined with vertebral plasty for patients with thoracic vertebral fracture due to senile osteoporosis is significant, the security and feasibility is high, which is worthy of clinical promotion and application.
出处 《中国医药导报》 CAS 2015年第24期102-106,共5页 China Medical Herald
基金 安徽省池州市科技计划(医疗卫生类)项目(池科字[2013]82号-1)
关键词 横突上嵴法 椎弓根螺钉植入术 椎体成形术 老年骨质疏松性胸椎骨折 Transverse ridge law Pedicle screw implantation Vertebral plasty Thoracic vertebral fracture due to se-nile osteoporosis
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