椎体成形联合体位复位治疗椎体压缩性骨折

Combination of percutaneous vertebroplasty and postural reduction for senile vertebral compression fractures

[目的]探索经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)联合体位复位法治疗老年人椎体压缩性骨折(vertebral compression fractures,VCFs)的疗效。[方法]分析2014~2015年间74例老年性椎体压缩性骨折患者的资料,其中行单纯PVP治疗者35例,行PVP联合体位复位者39例。比较两组疼痛和生活功能改善情况(VAS评分、ODI评分)。测量伤椎椎体前缘高度及矢状面Cobb角,探究两种治疗方案对于后凸畸形的矫正能力。并观察骨水泥漏、再骨折等相关手术并发症的发生率。[结果]两种治疗方案均能较好的改善疼痛症状,并恢复良好的日常生活功能。术前、术后、术后1年两者在VAS、ODI评分上均无统计学差异(P>0.05)。无论术后还是术后1年,PVP联合体位复位在恢复椎体前缘高度及矢状面Cobb角均较单纯PVP组有着明显的优势(P<0.05)。骨水泥漏发生率在两种治疗方案中无明显统计学差异(P>0.05)。术后再骨折及临近节段椎体骨折发生率两者均无明显统计学差异(P>0.05)。[结论]两种治疗方案均能较好的治疗胸腰椎骨折,缓解症状,恢复日常生活功能。PVP联合体位复位能更好的恢复椎体前缘高度,纠正后凸畸形。在骨水泥漏、再骨折等并发症中,两种治疗方案无明显差异。

[Objective] To investigate the clinical effects of the combination of percutaneous vertebroplasty and postural reduction for senile vertebral compression fractures. [Methods] From 2014 to 2015 , 74 cases of senile vertebral compres- sion fractures, including 35 cases in the PVP group and 39 cases in the PVP combined with postural reduction group, were retrospectively analyzed. The differences in visual analog scale scores and Oswestry disability index were compared. Imaging re- suhs were used to observe vertebral height and kyphotie angle. Bone cement leakage and complications of refracture and adja- cent segment fracture were analyzed. The data was compared with Student＇ s T-test or ANOVA. [Result] Both groups got less VAS and ODI scores after surgery treatment. But no significant difference between two groups was found in VAS scores and ODI either before or after surgery treatment. PVP combined with postural reduction had better performance in recovery of verte- bral height and relieving kyphotic angle. No significant difference in rate of cement leakage and complications of fractures was detected between the two groups. IConclusionl PVP combined with postural reduction had similar outcomes in pain alleviat- ing, but better performance in recovery of vertebral height anti relieving kyphotic angle, compared with PVP group. No signif- icant difference in complications of cement leakage and fractures was found between the two groups.