经皮椎体后凸成形术治疗创伤性胸腰椎椎体压缩性骨折的近期疗效

The Short-term Effect of Percutaneous Kyphoplasty on the Treatment of Traumatic Thoracolumbar Vertebral Compression Fractures

目的探讨经皮椎体后凸成形术(PKP)治疗创伤性胸腰椎椎体压缩性骨折的近期临床效果。方法方便选取该院2010年10月—2016年10月期间收治的100例胸腰椎椎体压缩性骨折患者,随机分为观察组和对照组,各50例。对照组采用传统的切开复位椎弓根固定术,观察组行经皮椎体后凸成形术,比较两组手术时间、出血量、住院时间及VAS评分等。结果对患者进行1年的随访,所有患者均为一期甲级愈合,无内固定物松动、脱落、断裂等并发症。观察组手术时间(45.3±6.7)min、出血量(50.7±8.4)m L、住院时间(5.7±1.3)d与对照组比较差异有统计学意义(P<0.05)。观察组术后2天VAS评分(3.29±1.20)分、术后1个月(2.1±1.3)分与对照组比较差异有统计学意义(P<0.05)。观察组术前Cobb角(14.42±1.24)°、术后1年(8.53±0.23)°与对照组比较差异无统计学意义(P>0.05)。结论对于创伤性胸腰椎椎体压缩性骨折患者采取经皮椎体后凸成形术治疗,效果确切,对于符合手术指征的患者,近期疗效肯定,值得临床推广。

Objective This paper tries to evaluate the short-term clinical effect of percutaneous kyphoplasty（PKP） in the treatment of traumatic thoracolumbar vertebral compression fractures. Methods 100 patients with thoracic and lumbar vertebral compression fractures treated in this hospital from October 2010 to October 2016 were selected. They were randomly divided into the observation group and the control group, with 50 cases in each group. The control group adopted the traditional incision and reduction pedicle fixation, the observation group adopted the percutaneous vertebral kyphoplasty, and the operation time, bleeding volume, hospitalization time and VAS score were compared between the two groups. Results All patients were followed up for 1 year. All patients were treated with grade I, and there was no complication such as loose fixation, shedding and rupture of internal fixation. The time of operation was（45.3±6.7）min, the amount of bleeding was（50.7±8.4）m L, the time of hospitalization was（5.7±1.3）d, significantly different from the control group（P0.05）. There were significant differences in VAS score of（3.29±1.20）points, one month after operation of（2.1±1.3）points between the two groups after operation（P0.05）. The Cobb in the observation group before operation was（14.42±1.24）°, and one year after operation was（8.53±0.23）°, without significant difference of the control group（P0.05）. Conclusion For patients with traumatic thoracolumbar vertebral compression fractures, percutaneous vertebroe kyphoplasty is effective. For patients who meet the indications for surgery, the short-term curative effect is definite, so it is worthy of clinical promotion.