摘要
目的比较经椎弓根椎体内植骨加短节段内固定与单纯短节段内固定治疗单节段骨质疏松性脊柱骨折的临床效果。方法选择2015年6月—2018年1月收治的单节段骨质疏松性脊柱骨折128例,据手术方案分为观察组和对照组各64例。观察组行经椎弓根椎体内植骨加短节段内固定术治疗,对照组行单纯短节段内固定术治疗。观察2组围术期指标、治疗后疼痛改善情况及随访6个月、1年后Cobb角变化与椎体高度丢失量。结果2组围术期指标比较差异无统计学意义(P>0.05)。2组术后视觉模拟评分法(VAS)评分较术前降低,日本骨科学会下腰痛评分标准(JOA)评分较术前升高,且观察组VAS评分低于对照组,JOA评分高于对照组(P<0.05)。2组术后6个月、1年椎体高度丢失量、椎体Cobb角均小于术前,且观察组小于对照组(P<0.05,P<0.01)。结论经椎弓根椎体内植骨加短节段内固定术治疗单节段骨质疏松性脊柱骨折可明显缓解疼痛,术后可减少椎体高度、Cobb角丢失,内固定物发生松动和断裂的概率明显降低。
Objective To compare the clinical effect of transpedicular intracorporeal grafting combined with short-segment fixation and simple short-segment fixation for single-segment osteoporotic vertebral fracture.Methods A total of 128 patients with single-segment osteoporotic spinal fractures who were treated in our hospital between June 2015 and January 2018 were enrolled in this study.According to the operation options,they were divided into observation group and control group,with 64 cases in each group.The observation group was treated with transpedicular intracorporeal grafting combined with short-segment fixation,while the control group was treated with simple short-segment fixation.Perioperative indicators,the improvement of pain after treatment,vertebral Cobb angle and vertebral height loss in 6 and 12 months after follow-up were compared between the two groups.Results The perioperative indicators did not differ significantly between the two groups(P>0.05).After operation,the VAS scores of the two groups were lower than those before operation,and the JOA scores of the two groups were higher than that before operation.The VAS score of the observation group was lower than that in control group,and the JOA score was higher than that in control group(P<0.05).The loss of vertebral height and Cobb angle of vertebral body were less than those before operation in two groups in 6 and 12 months after operation,which were less in the observation group than in the control group(P<0.05,P<0.01).Conclusion The treatment of single-segment osteoporotic vertebral fracture with transpedicular intracorporeal grafting and short-segment internal fixation can significantly alleviate the pain,and it can reduce the loss of vertebral height and Cobb angle after operation.In addition,the incidence of loosening and fracture of internal fixation is significantly reduced.
作者
刘江川
黄海汛
江洋
黄宏杰
陈铭
陈康
范海泉
LIU Jiang-chuan;HUANG Hai-xun;JIANG Yang;HUANG Hong-jie;CHEN Ming;CHEN Kang;FAN Hai-quan(Department of Spinal Orthopedics,Nuclear Industry 416 Hospital the Second Affiliated Hospital of Chengdu Medical College,Chengdu 610051,China)
出处
《解放军医药杂志》
CAS
2020年第4期76-79,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
四川省卫生和计划生育委员会科研课题(18PJ107)。
关键词
骨质疏松性骨折
脊柱骨折
椎弓根椎体内植骨
短节段内固定
椎体高度
COBB角
Osteoporotic fractures
Spinal fractures
Transpedicular intracorporeal grafting
Short segment fixation
Vertebral height
Cobb angle
