Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, No. 152 Yucai Road, XiaoShan District Hangzhou, Zhejiang Province, China.
Department of Anesthesia Institute, HangZhou Hospital of Traditional Chinese Medical. No. 453 Tiyuchang Road, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2022 Mar 11;101(10):e29011. doi: 10.1097/MD.0000000000029011.
To evaluate the feasibility, efficacy, and safety of minimally invasive pedicle screw (MIPS) fixation, including the fractured vertebra, combined with percutaneous vertebroplasty (PVP) for the treatment of acute thoracolumbar osteoporotic compression fracture in middle-age and elderly individuals.Between January 2016 and August 2019, a total of 30 patients, with a mean age of 69.4 years (range, 58-75 years), who experienced thoracic or lumbar fracture without neurological deficits, underwent the MIPS procedure combined with PVP. Preoperative and postoperative pain were assessed using a visual analog scale and Oswestry Disability Index. Cobb angles and anterior column height were measured on lateral radiographs before surgery and at 3 days, 1, 3, and 6 months, and 1 and 2 years at final follow-up after surgery.All patients underwent surgery successfully, with a mean follow-up of 18.2 ± 5.7 months (range, 12-45 months). Mean preoperative visual analog scale score decreased from 7.3 ± 2.2 to 1.4 ± 0.3 at the final follow-up (P < .05). Mean preoperative Oswestry Disability Index decreased from 84.2 ± 10.3 to 18.8 ± 7.5 (P < .05) at the final follow-up. The Kyphosis angle of operative segment was improved from preoperative (21.38 ± 1.68)° to (4.01 ± 1.38)° 3 days postoperatively and (5.02 ± 1.09)° at final follow-up (P < .05). The anterior vertebral height was improved from preoperative (49.86 ± 6.50)% to (94.01 ± 1.79)% 3 days postoperatively and (91.80 ± 1.88)% at final follow-up (P < .05). No significant changes in vertebral body height restoration were observed during 2 years of follow-up after surgery. In addition, there were no instrumentation failures or complications in any of the patients.MIPS, including the fractured vertebra, combined with PVP, was a reliable and safe procedure, with satisfactory clinical and radiological results for the treatment of thoracolumbar osteoporotic compression fracture in patients without neurological deficits.
评估微创经皮椎弓根螺钉(MIPS)固定术,包括骨折椎体,结合经皮椎体后凸成形术(PVP)治疗中老年急性胸腰椎骨质疏松性压缩骨折的可行性、疗效和安全性。
2016 年 1 月至 2019 年 8 月,共 30 例患者,平均年龄 69.4 岁(范围 58-75 岁),无神经功能缺损的胸腰椎骨折患者,行 MIPS 手术联合 PVP 治疗。术前和术后疼痛采用视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评估。术前和术后 3 天、1 个月、3 个月、6 个月和 2 年,测量侧位 X 线片上的 Cobb 角和前柱高度。所有患者均成功完成手术,平均随访 18.2±5.7 个月(12-45 个月)。术前 VAS 评分从 7.3±2.2 降至末次随访时的 1.4±0.3(P<.05)。术前 ODI 从 84.2±10.3 降至末次随访时的 18.8±7.5(P<.05)。手术节段后凸角从术前(21.38±1.68)°改善至术后 3 天(4.01±1.38)°和末次随访时(5.02±1.09)°(P<.05)。术前椎体前缘高度为(49.86±6.50)%,术后 3 天提高至(94.01±1.79)%,末次随访时提高至(91.80±1.88)%(P<.05)。术后 2 年随访期间,椎体高度恢复无明显变化。此外,所有患者均无器械失败或并发症。
综上所述,对于无神经功能缺损的胸腰椎骨质疏松性压缩骨折患者,MIPS 联合 PVP 是一种可靠、安全的治疗方法,具有满意的临床和影像学结果。