床托复位结合经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折

Thoracic and Lumbar Vertebral Compression Fracture Treated by Reposition Support Mattress Closed Reduction combining Percutaneous Vertebroplasty

目的:探索复位床托闭合复位结合经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性胸腰椎压缩骨折的疗效。方法:将48例骨质疏松性胸腰椎骨折患者随机分为治疗组和对照组各24例。治疗组为床托复位结合椎体成形术,对照组为经皮椎体后凸成形术。比较两组手术前后的VAS评分,体征、活动能力评分;伤椎前中高度压缩率和脊柱后凸Cobb角。结果:所有患者的VAS评分;体征、活动能力评分,术后椎体前中高度压缩率、后凸Cobb角度较术前均有显著的改善(P<0.05);两组组间的伤椎前中高度恢复进行比较,差异有统计学意义(P<0.05)。结论:床托复位结合PVP与经皮椎体后凸成形术都能有效的恢复伤椎高度及后凸角,前者恢复伤椎椎体前缘高度比后者优。床托复位结合PVP治疗骨质疏松性胸腰椎压缩骨折,疗效肯定,值得临床推广应用。

Objective：To explore the therapeutic effects of the reposition support mattress （RSM） closed reduction in percutaneous vertebroplasty （PVP） for the treatment of the thoracic and lumbar vertebrae compression fractures. Methods：Forty-eight patients with osteoporotic vertebral compression fractures were divided into two groups, one group treated with RSM closed reduction combined with PVP, and the other group treated with preoperative reduction and percutaneous kyphoplasty （PKP）. The results were evaluated with visual analog scale （VAS）, the symptoms and sign, vertebral height loss and Cobb angle of vertebral compression fractures. Results： Compared with the preoperative treatment, the VAS, symptoms and signs, the vertebra1 height loss and Cobb angle after the operation were significantly improved in both groups （P〈0. 05）. There was also significant difference in the recovery of vertebral height between the two groups （P〈0.05）. Conclusion：The RSM closed reduction combined with PVP and PKP is effective in the treatment of osteoporotic vertebral compression fractures. The former in the recovery of the front of the vertebral is better than the latter.