Lu Yu-Zhou, Wang Yu, Yang Xiao-Xu, Wu Cheng-Qiang, Zhang Shou-Cui, Wang Jin-Guo, Wu Ya-Dong, Qin Dong, Ding Lin
Rizhao Hospital of Traditional Chinese Medicine Affiliated to Shandong Traditional Chinese Medicine University, Rizhao 276800, Shandong, China.
Zhongguo Gu Shang. 2024 Jan 25;37(1):21-6. doi: 10.12200/j.issn.1003-0034.20220564.
To investigate the clinical effect of modified suspension reduction method combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures.
From February 2020 to October 2021, 92 patients with thoracolumbar osteoporotic compression fracture were treated by percutaneous vertebroplasty. According to different treatment methods, they were divided into the observation group and the control group. The observation group was treated with modified suspension reduction and then percutaneous vertebroplasty, while the control group was treated with percutaneous vertebroplasty alone. The observation group (47 cases), including 20 males and 27 females, the age ranged from 59 to 76 years old with an average of (69.74±4.50) years old, fractured vertebral bodies:T(2 cases), T(7 cases), T(19 cases), L(14 cases), L(5 cases);the control group(45 cases), including 21 males and 24 females, the age ranged from 61 to 78 years old with an average of (71.02±3.58) years old, fractured vertebral bodies:T(3 cases), T(8 cases), T(17 cases), L(12 cases), L(5 cases);The leakage of bone cement were observed, the visual analogue scale (VAS), Oswestry lumbar dysfunction index (ODI), anterior vertebrae height (AVH), Cobb angle of kyphosis and the amount of bone cement injected before and after operation were recorded and compared between the two groups.
All patients were followed up, ranged from 6 to10 with an average of (8.45±1.73) months. Two patients ocurred bone cement leakage in observation group and 3 patients in control group. AVH of observation group increased (<0.05) and Cobb angle of injured vertebrae decreased (<0.05). Cobb angle of injured vertebrae and AVH of the control group were not significantly changed (>0.05). Cobb angle of injured vertebrae of the observation group was lower than that of control group (<0.05) and AVH was higher than that of the control group (<0.05). In the observation group, VAS before operation and 1 week, 3 and 6 months after operation respectively were(7.32±1.05) scores, (3.56±1.18) scores, (1.83±0.67) scores, (1.27±0.34) scores, and ODI were(40.12±14.69) scores, (23.76±10.19) scores, (20.15±6.39) scores, (13.45±3.46) scores. In the control group, VAS before operation and 1 week, 3 and 6 months after operation respectively were(7.11±5.26) scores, (3.82±0.68) scores, (1.94±0.88) scores, (1.36±0.52) scores, and ODI were(41.38±10.23) scores, (25.13±14.22) scores , (20.61±5.82) scores, (14.55±5.27) scores . The scores of VAS and ODI after operation were lower than those before operation (<0.05), but there was no significant difference between the two groups (<0.05).
Modified suspension reduction method combined with PVP surgery for osteoporotic thoracolumbar compression fractures has achieved good clinical results, which can effectively relieve lumbar back pain, restore vertebral height, correct kyphosis, improve lumbar function and patients' quality of life.
探讨改良悬吊复位法联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折的临床效果。
选取2020年2月至2021年10月收治的92例胸腰椎骨质疏松性压缩骨折患者，均采用经皮椎体成形术治疗。根据治疗方法不同分为观察组和对照组。观察组采用改良悬吊复位后行经皮椎体成形术，对照组单纯行经皮椎体成形术。观察组47例，男20例，女27例，年龄59～76岁，平均（69.74±4.50）岁，骨折椎体：T（2例），T（7例），T（19例），L（14例），L（5例）；对照组45例，男21例，女24例，年龄61～78岁，平均（71.02±3.58）岁，骨折椎体：T（3例），T（8例），T（17例），L（12例），L（5例）。观察两组骨水泥渗漏情况，记录并比较两组手术前后视觉模拟评分法（VAS）、Oswestry腰椎功能障碍指数（ODI）、椎体前缘高度（AVH）、后凸Cobb角及骨水泥注入量。
所有患者均获随访，随访时间6～10个月，平均（8.45±1.73）个月。观察组有2例发生骨水泥渗漏，对照组有3例发生骨水泥渗漏。观察组AVH增加（<0.05），伤椎Cobb角减小（<0.05）；对照组伤椎Cobb角及AVH无明显变化（>0.05）。观察组伤椎Cobb角低于对照组（<0.05），AVH高于对照组（<0.05）。观察组术前及术后1周、3个月、6个月VAS评分分别为（7.32±1.05）分、（3.56±1.18）分、（1.83±0.67）分、（1.27±0.34）分，ODI分别为（40.12±14.69）分、（23.76±10.19）分、（20.15±6.39）分、（13.45±3.46）分；对照组术前及术后1周、3个月、6个月VAS评分分别为（7.11±5.26）分、（3.82±0.68）分、（1.94±0.88）分、（1.36±0.52）分，ODI分别为（41.38±10.23）分、（25.13±14.22）分、（20.61±5.82）分、（14.55±5.27）分。两组术后VAS、ODI评分均低于术前（<0.05），但两组间比较差异无统计学意义（<0.05）。
改良悬吊复位法联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折临床效果良好，能有效缓解腰背部疼痛，恢复椎体高度,矫正后凸畸形，改善腰椎功能及患者生活质量。
