经皮椎弓根螺钉固定联合椎体成形术治疗GenantⅢ度骨质疏松性椎体压缩骨折

[Percutaneous pedicle screw fixation combined with vertebroplasty for the treatment of Genant Ⅲ degree osteoporotic vertebral compression fractures].

作者信息

Li Zhi-Kun, Xu You-Jia, Xu Wei, Zhu Xiao-Dong, Li Guang-Fei, Chen Chao, Li Yi-Fan, Wang Yi

机构信息

Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China.

出版信息

Zhongguo Gu Shang. 2020 Sep 25;33(9):807-13. doi: 10.12200/j.issn.1003-0034.2020.09.004.

DOI:10.12200/j.issn.1003-0034.2020.09.004

PMID:32959567

Abstract

OBJECTIVE

To investigate the clinical effect of percutaneous pedicle screw fixation(PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of Genant Ⅲ degree osteoporotic vertebral compression fractures (OVCFs).

METHODS

The hospitalized 83 patients with Genant Ⅲ degree OVCFs treated by PPSF combined with PVP from June 2015 to June 2017 were retrospectively analyzed, and 83 patients treated by PVP alone from January 2013 to June 2016 were randomly selected as the control group. There were 19 males and 64 females with an average age of (73.6±11.0) years in combined group with treatment of PPSF and PVP. There were 15 malesand 68 females with an average age of (75.5±10.6) years in control group. The anterior edge height of the vertebral body and Cobb angle before operation, 1 day, and 6, 12, 24 months after operation were compared between two groups. Visual analogue scale(VAS) and Oswestry Disability Index (ODI) were used to assess the pain level and daily lumbar dysfunction for patients, respectively. The complications were observed.

RESULTS

The follow-up time of all patients was more than 2 years. The combined group and control group were (24.3±10.2) months and (27.5±14.8) months, respectively. There were no statistically significant differences in the anterior edge height of the vertebral body and Cobb angle at 1 day after surgery between two groups (>0.05), and there were statistically significant differences at 6, 12, 24 months after surgery between two groups (<0.01). The difference in ODI and VAS scores at 6 and 12 months after operation between two groups was statistically significant (<0.05). Postoperative complications incontrol group were higher than those in the combined group.

CONCLUSION

PPSF combined with PVP for the treatment of Genant Ⅲ degree OVCFs is superior to PVP alone in terms of vertebral height loss, patient satisfaction, and complications.

摘要

目的

探讨经皮椎弓根螺钉固定术（PPSF）联合经皮椎体成形术（PVP）治疗GenantⅢ度骨质疏松性椎体压缩骨折（OVCFs）的临床效果。

方法

回顾性分析2015年6月至2017年6月采用PPSF联合PVP治疗的83例GenantⅢ度OVCFs住院患者，并随机选取2013年1月至2016年6月单纯采用PVP治疗的83例患者作为对照组。PPSF联合PVP治疗组中男性19例，女性64例，平均年龄（73.6±11.0）岁。对照组中男性15例，女性68例，平均年龄（75.5±10.6）岁。比较两组患者术前、术后1天、术后6、12、24个月时椎体前缘高度和Cobb角。分别采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评估患者的疼痛程度和日常腰椎功能障碍情况。观察并发症发生情况。

结果

所有患者随访时间均超过2年。联合组和对照组的随访时间分别为（24.3±10.2）个月和（27.5±14.8）个月。两组术后1天时椎体前缘高度和Cobb角比较，差异无统计学意义（>0.05），术后6、12、24个月时两组比较，差异有统计学意义（<0.01）。两组术后6、12个月时ODI和VAS评分比较，差异有统计学意义（<0.05）。对照组术后并发症高于联合组。