椎体成形术治疗不愈合的胸腰椎陈旧性骨折疗效分析

Efficacy of vertebroplasty in the treatment of ununited vertebral fracture

目的评价靶向穿刺椎体成形术治疗不愈合的胸腰椎陈旧性骨折的疗效。方法 2013年8月～2014年6月,笔者将32例不愈合的陈旧性椎体骨折患者（男性13例,女性19例;年龄63～82岁,平均73.6岁）分为两组：A组14例,为卧床非手术治疗,B组18例,行靶向穿刺椎体成形术治疗。分别测量并比较两组患者治疗前1d、治疗后1d,1个月及1年病椎前缘压缩率,同时行疼痛视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）评价治疗效果。结果靶向穿刺椎体成形手术组患者疗效优于非手术治疗组患者,术后椎体前缘压缩率较术前有明显改善,差异有统计学意义（P〈0.05）。手术组患者的术后VAS和ODI评分优于非手术治疗组,两者差异有统计学意义（P〈0.05）。结论对于不愈合的陈旧性椎体骨折,通过定向穿刺,在骨折部位注射骨水泥,增强了骨折椎体的稳定性,明显缓解了患者的疼痛,改善了患者的生活质量。

Objective To evaluate the efficacy of the targeted intraoperative puncture vertebroplasty for the treatment of ununited vertebral fracture.Methods A total of 32 patients with ununited vertebral fractures were di-vided into 2 groups：group A and group B.Group A was bed rest group without operation,while cases in group B were treated with targeted puncture vertebroplasty surgery.The effect of surgery was measured by the compression ratio of anterior vertebral body,visual analogue scale （ VAS） and Oswestry Disability Index （ ODI） one day before the operation,one day,one month and one year after operation.Results The effect in the targeted puncture verte-broplasty group was better than that in group B. The compression ratio of anterior vertebral body in group B im-proved significantly compared with group A and the difference was statistically significant （ P〈0.05） .The postop-erative VAS and ODI scores were better than that of group B,the difference was statistically significant（P〈0.05）. Conclusion Directional puncture and injection of bone cement in the fracture site can enhance the stability of the vertebral body and significantly alleviate the pain and improve life quality of patients with old ununited vertebral fractures.