中医正骨联合椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的临床研究

The Clinical Efficacy of PKP Combined with Traditional Chinese Medicine Bone-setting Manipulation on the Osteoporotic Vertebral Compression Fractures

目的:观察中医正骨结合椎体后凸成形术(PKP术)治疗骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法:回顾性分析2016年1至2016年12月83例单一节段OVCF患者,均为接受椎体后凸成形术的病例资料。其中中医正骨手法整复联合PKP术40例(A组,观察组);单纯采用PKP术43例(B组,对照组)。比较两组治疗效果、VAS评分、Oswestry功能指数(ODI),并通过X线片对术前、术后椎体高度变化及术后骨水泥渗漏发生率进行比较。结果:通过对两组的各项指标比较,在术前VAS评分和术前骨折压缩率上差异无统计学意义(P>0.05)。在术后1d、术后3个月VAS评分、ODI评分较术前明显降低,差异有统计学意义(P<0.001)。观察组骨水泥渗漏率明显低于对照组,差异有统计学意义(P=0.036)。观察组术后椎体高度恢复明显优于对照组,差异有统计学意义(P=0.001)。结论:与单纯PKP术相比,中医正骨手法整复联合PKP术能有效的缓解病人疼痛、改善生活质量;同时能够降低的骨水泥渗漏率、改善术后椎体高度的恢复,是一种治疗骨质疏松性椎体压缩性骨折的安全、有效方法。

Objective：To observe the curative effect of PKP combined with traditional Chinese medicine bone-setting manipulation on the osteoporotic vertebral compression fractures.Methods：From January 2016 to December 2016,83 OVCF（osteoporotic vertebral compression fracture）patients underwent the PKP surgery in our department were randomly divided into two groups.The observation group（n=40）was given PKP combined with TCM bone-setting manipulation,and the control group（n=43）was simply administered with PKP.All the patients were followed for at least six months.The therapeutic effect,visual analogue scale（VAS）and oswestry disability index（ODI）of the two groups were compared and the X-ray films were used to compare the preoperative and postoperative vertebral height changes and the incidence of postoperative cement leakage.Results：There was no significant difference in preoperative VAS score and ODI between the two groups.At 1 day and three months after operation,the VAS score and ODI in two groups were significantly lower than those before the operation,and the difference was highly significant（P〈0.001）.The leakage rate of bone cement in the observation group was significantly lower than that of the control group（P=0.036）,and the height recovery of the vertebral body in the observation group was obviously better than that of the control group（P=0.001）.The differences were statistically significant（P〈0.05）.Conclusion：Traditional Chinese medicine bone-setting manipulation combined with PKP surgery can reduce the lower back pain and the leakage rate of bone cement by improving the recovery of vertebral height.It is an effective method for the treatment of osteoporotic vertebral compression fractures.