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经皮椎体成形术联合椎弓根螺钉固定治疗创伤性胸腰椎压缩性骨折。

Pedicle Screw Fixation with Percutaneous Vertebroplasty for Traumatic Thoracolumbar Vertebral Compression Fracture.

机构信息

Department of Neurosurgery, Gaziantep Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey.

Department of Orthopedics and Traumatology, Alanya Alaaddin Keykubat University Alanya Training and Research Hospital, Alanya, Turkey.

出版信息

Niger J Clin Pract. 2021 Sep;24(9):1360-1365. doi: 10.4103/njcp.njcp_47_20.

Abstract

OBJECTIVE

This study aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of the thoracolumbar vertebral compression fracture (VCF) without neurologic deficits.

MATERIALS AND METHODS

This was a prospective observational study. Between January 2015 and December 2018, 62 patients who had suffered from traumatic thoracolumbar (VCF) burst fractures without neurologic deficits were included in this study. The patients were divided into two groups as follows: patients who underwent PPSF combined with PVP (PPSF-PVP Group; n = 24) and patients who underwent only PPSF (PPSF Group; n = 38). The patients were (PPSF and PPSF-PVP Group) followed up for more than 9 months. The kyphotic angle, compression ratio, and visual analog scale (VAS) score for back pain were analyzed and compared between the two groups.

RESULTS

The patients were followed up for an average of 9.1 months. Hospital stay significantly decreased in PPSF-PVP Group (P < 0.001). The median VAS score significantly decreased after the surgery in both the groups (P < 0.005), and mean VAS scores in PPSF-PVP Group were significantly lower than those in PPSF Group. No significant (P > 0.005) changes in local kyphosis and the vertebral body height gains obtained at the end of the follow-up period in PPSF-PVP Group. However, local kyphosis increased significantly (P < 0.005) and the central and anterior vertebral body height decreased significantly (P < 0.005) when compared with the PPSF-PVP Group.

CONCLUSION

PPSF combined with PVP procedure is a good choice for the treatment of traumatic thoracolumbar VCF; however, due to the lack of long-term follow-up data, concern still exists regarding the effects of pedicle screw procedure after PVP.

摘要

目的

本研究旨在评估经皮椎弓根螺钉固定(PPSF)联合经皮椎体成形术(PVP)治疗无神经功能缺损的胸腰椎压缩性骨折(VCF)的临床疗效。

材料和方法

这是一项前瞻性观察研究。2015 年 1 月至 2018 年 12 月,纳入了 62 例无神经功能缺损的创伤性胸腰椎(VCF)爆裂骨折患者,将其分为两组:行 PPSF 联合 PVP(PPSF-PVP 组;n = 24)和仅行 PPSF(PPSF 组;n = 38)的患者。两组患者均随访时间超过 9 个月。分析比较两组患者的后凸角、压缩比和腰痛视觉模拟评分(VAS)。

结果

患者平均随访 9.1 个月。PPSF-PVP 组的住院时间明显缩短(P < 0.001)。两组患者术后 VAS 评分中位数均显著降低(P < 0.005),PPSF-PVP 组 VAS 评分均值明显低于 PPSF 组。PPSF-PVP 组在随访期末局部后凸角和椎体高度增加无明显变化(P > 0.005)。然而,与 PPSF-PVP 组相比,局部后凸角明显增加(P < 0.005),中心和前缘椎体高度明显降低(P < 0.005)。

结论

PPSF 联合 PVP 是治疗创伤性胸腰椎 VCF 的一种较好选择;然而,由于缺乏长期随访数据,对 PVP 后椎弓根螺钉手术的效果仍存在担忧。

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