新鲜椎体压缩性骨折手术时机的选择及临床分析

Clinical research of the operative juncture of fresh osteoporotic vertebral compression fractures.

目的量化新鲜骨质疏松性椎体压缩性骨折在SKy后凸成形术后脊柱畸形、活动能力和疼痛缓解程度。探讨有关手术时机的问题。方法30例新鲜骨质疏松性椎体压缩性骨折行SKy后凸成形术治疗。分析术前术后站立位X线片的矢状位成角。术后用视觉类比评分法(VAS)衡量患者的疼痛缓解情况,用O'Brien法评估患者活动能力的改善水平,以及调查患者对手术的满意度。结果在这个序列中,SKy后凸成形术纠正局部后凸畸形的平均矫正角度3.05°±3.45°(0°～9°)。在术后第三天调查显示:所有患者疼痛明显减轻,视觉类比评分法术前9.27±2.02,术后为2.19±1.32;活动力水平增加,术前3.56±1.49,术后1.00±0.00°满意度调查,所有患者对手术疗效满意。结论SKy后凸成形术可以提高患者的生理功能,减轻疼痛。并且可以部分矫正新鲜骨质疏松性椎体压缩性骨折所导致的后凸畸形;在骨质疏松性椎体压缩性骨折发生后应尽早应用。

Objective To measure changes in spinal deformity, activity level, and pain after Skyphoplasty for the treatment of fresh osteoporotic vertebral compression fractures, and to study operative juncture. Methods Thirty consecutive patients with fresh osteoporotic vertebral compression fractures were treated by SKyphoplasty. Sagittal alignment was analyzed from lateral radiographs （pre- and postSKyphoplasty）. Patient surveys were used to assess pain relief, improvement in activity, and satisfaction with the surgical procedure by VAS and O＇Brien. Results In this eohort,a mean of 3.05° ± 3.45° （0°～ 9°） of correction of local spinal kyphosis was achieved with SKy- phoplasty. Patient surveys revealed the pain scores dropped from （ 9.27 ± 2.02 ） to （ 2.19 ± 1.32 ） and initial physical mobility scores were （3.56 ± 1. 49 ）, falling to （ 1. 00 ＋ 0.00 ） on the 3rd day after operation. Significant improvement was noted in pain and physical function. All patients were satisfied with the procedure. Conclusion SKy- phoplasty improves physical function, reduces pain, and may correct kyphotic deformity associated with fresh osteoperotic vertebral compression fractures. So it would be performed as early as possible after fractures.