过伸复位结合经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折

Combination of hyperextensive reposition and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture

目的探讨过伸复位结合经皮椎体后凸成形术治疗骨质疏松性压缩骨折的临床疗效。方法根据治疗方式的不同,将56例椎体压缩性骨折(OVCF)患者分为观察组和对照组,观察组采用在C臂透视下行过伸复位、体外定位结合经皮球囊扩张并注入骨水泥椎体后凸成形术,对照组采用经皮椎体成形术。对术前、术后3天、术后6个月的疼痛评分、椎体中线高度及矢状面Cobb角变化进行临床和影像学评估。结果观察组手术时间与术后并发症与对照组之间差异无统计学意义(P>0.05),观察组术后6个月视觉模拟评分、伤椎椎体中线高度显著高于对照组,而矢状面Cobb角改变程度显著低于对照组,差异有统计学意义(P<0.05)。结论过伸复位、体外定位结合经皮椎体后凸成形术治疗骨质疏松性OVCF具有创伤小、安全性较高、止痛效果良好、术后可早期下地活动等优点,是临床治疗OVCF的一种有效微创方法。

Objective To explore the effectiveness of hyperextensive reposition combined with percutaneous kyphoplasty （PKP） in the treatment of osteoporotic vertebral compression fracture （OVCF） .Methods A total of 56 OVCF patients were divided into observation group ,treated with hyperextensive reposition combined with percutane-ous kyphoplasty after in vitro localization ,and control group ,treated with percutaneous vertebroplasty .Scores of pain evaluation ,vertebral height and Cobb angle were assessed before operation ,and 3 days and 6 months after operation . Results Surgical time and incidence of complication in observation group were not different with those in control group （P〉0 .05） ,but Cobb angle was lower than group control （P〈0 .05） at 6 months after operation （P〈0 .05） . Conclusion Combination of hyperextensive reposition and percutaneous kyphoplasty after in vitro localization for the treatment of OVCF might be minimally invasive ,safe and effective to alleviate pain and shorten period of recum-bence .