术前体位复位对骨质疏松性胸腰椎骨折PKP术后疗效的影响

目的探讨术前体位复位对骨质疏松性胸腰椎骨折经皮椎体后凸成形术（PKP）疗效的影响。方法选择自2009年1月至2012年1月骨质疏松所致严重椎体骨折患者48例，术前采用体位复位，复位后行PKP，比较患者术前及术后椎体高度及后凸角度、VAS评分、Oswestry评分及活动能力评分。结果经术前体位复位，伤椎前缘高度、中线高度较术前有显著性增加（P〈0．05），术后前缘高度及中线高度较体位复位后均有显著性增加（P〈0．05）。48例患者均顺利安全完成手术，术后伤椎前缘高度、中线高度、后缘高度较术前有显著性增加（P〈0．05），术后VAS及Oswestry评分较术前有显著性下降（P〈0．05）；术后6个月VAS评分与术前比较差异有统计学意义（P〈0．01），术后6个月Oswestry评分与术前比较差异有统计学意义（P〈0．01）；术后及术后6个月后凸角度较术前有显著性下降（P〈0．01），患者活动能力显著性增加（P〈0．05或0．01）。结论术前体位复位联合PKP术治疗严重骨质疏松性胸腰椎骨折患者，可显著改善手术效果，提高患者生活质量，减轻患者的痛苦。

Objective To investigate the efficacy of preoperative postural reset for PKP for osteoporotic thoracolumbar fractures. Methods 48 patients with severe vertebral fractures from January 2009 to January 2012 due to osteoporosis in patients accepted preoperative postural reset before percutaneous vertebral kyphoplasty. Preoperative and postoperative vertebral body height and kyphosis, VAS score, Oswestry score and activity score were observed. 48 cases accepted operation successfully, postoperative fractured vertebral anterior height , the midline height the posterior height group after treatment significant increased compared with the preoperative （ P〈0.05 ） . After preoperative postural reset the fractured vertebral anterior height the midline height significantly increased than before surgery （ P〈0.05 ） , compared with the preoperative postoperative VAS and Oswestry score decreased significantly （ P〈0.05 ） , VAS score for the 6 months postoperatively compared with the preoperative had significant difference （ P〈0.01 ） ; postoperative Oswestry at six months compared with the preoperative decreased significantly, and the difference was statistically significant （ P〈0.01 ） . In patients after surgery and postoperative kyphosis for six months significantly decreased compared with the preoperative （ P〈0.01 ） and activity of daily living in patients after surgery and 6 months postoperatively significantly increased （ P〈0.05, P〈0. 01 ） . Conclusion Preoperative postural reset joint PKP surgery for severe osteoporotic thoracolumbar fracture patients can significantly improve the Results of operations, increase the quality of life and alleviate the suffering of the patient.