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椎弓根螺钉结合骨水泥椎体成形术对骨质疏松性胸腰椎骨折患者远期疗效的前瞻性研究 被引量:15

Effects of pedicle screw combined with bone cement vertebroplasty on the long-term efficacy in patients with osteoporotic thoracolumbar fracture
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摘要 目的探讨椎弓根螺钉结合骨水泥椎体成形术对骨质疏松性胸腰椎骨折(osteoporotic thoracolumbar fracture,OTF)患者远期疗效的影响。方法选取2013年6月至2016年6月我院收治的100例OTF患者,依据治疗方法分为结合组(n=50)和螺钉组(n=50),螺钉组给予椎弓根螺钉内固定术治疗,结合组在此基础上给予骨水泥椎体成形术治疗。结果结合组术后椎体前缘高度明显高于螺钉组,结合组术后椎体压缩率、后凸Cobb’s角、受压面积明显低于螺钉组,差异有统计学意义(P=0.000);结合组螺钉并发症发生率明显低于螺钉组,差异有统计学意义(P=0.047);结合组术后6、12个月疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数问卷表(oswestry dability index,ODI)评分明显低于螺钉组,差异有统计学意义(P=0.000)。结论椎弓根螺钉结合骨水泥椎体成形术可有效改善OTF患者伤椎骨质高度和受压状态,有利于减少螺钉并发症的发生,且远期疗效好,值得临床推广。 Objective To discuss effects of pedicle screw combined with bone cement vertebroplasty on the long-term efficacy in patients with osteoporotic thoracolumbar fracture( OTF). Methods A total of 100 patients with OTF were selected from June 2013 to June 2016 in our Hospital. According to the treatment method, all patients were divided into combined group( n = 50) and nail group( n = 50). Nail group was treated with pedicle screw fixation, while combined group was treated with pedicle screw fixation plus bone cement vertebroplasty. Results The postoperative front vertebral height of combined group was significantly higher than that of nail group, and the postoperative vertebral compression rate, convex Cobb angle, compression area of combined group were significantly lower/less than those of nail group with statistical significance( P = 0.000). The screw complication rate of combined group was significantly lower than that of nail group with statistical significance( P = 0.047). The postoperative pain visual simulation score( VAS) and Oswestry functional disorder index( ODI) of the combined group were significantly lower than those of nail group with statistical significance( P = 0.000). Conclusions Pedicle screws combined with bone cement vertebroplasty can effectively improve the injured vertebral height and pressure condition in patients with OTF. It is beneficial to reduce the complications of screws with better long-term efficacy. It's worth for further clinical promotion.
作者 高贵营 夏庆福 黄立军 张玉双 田新奇 GAO Gui-ying;XIA Qing-fu;HUANG Li-jun;ZHANG Yu-shuang;TIAN Xin-qi(Beijing Chaoyang Emergency Medical Center,Beijing,100122,China)
出处 《中国骨与关节杂志》 CAS 2018年第7期494-498,共5页 Chinese Journal of Bone and Joint
关键词 椎体成形术 骨质疏松性骨折 胸椎 腰椎 治疗结果 Vertebroplasty Osteoporotic fractures Thoracic vertebrae Lumbar vertebrae Treatmentoutcome
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