椎体成形术联合体位复位术在创伤性胸腰椎骨折临床治疗中的应用效果

Application Effect of Vertebroplasty Combined with Postural Reduction in Clinical Treatment of Traumatic Thoracolumbar Fracture

目的探究椎体成形术联合体位复位术在创伤性胸腰椎骨折患者的应用效果。方法选择2013年2月—2018年2月该院收治的创伤性胸腰椎骨折患者120例,随机分为对照组、观察组,各60例。对照组行经皮球囊扩张椎体后凸成形术(PKP)治疗,观察组行经皮穿刺椎体成形术(PVP)联合体位复位术治疗。对比两组临床疗效及围术期指标(VAS评分、Cobb角、椎体前缘及后缘高度)。结果两组临床总有效率对比,差异无统计学意义(P>0.05)。两组治疗前VAS评分、Cobb角、椎体高度对比,差异无统计学意义(P>0.05);治疗后两组VAS评分及Cobb角对比,差异无统计学意义(P>0.05);观察组治疗后椎体前缘及后缘高度分别为(28.31±4.47)mm、(32.64±4.53)mm,显著高于对照组的(24.57±3.64)mm、(30.59±4.72)mm,差异有统计学意义(t=5.066、4.427,P<0.05)。结论 PKP与PVP结合体位复位均能有效治疗创伤性胸腰椎骨折,其中PKP恢复椎体高度的效果较好,PVP具有适应证更广,操作相对简单,价格较低等优势。

Objective To investigate the effect of vertebroplasty combined with postural reduction in patients with traumatic thoracolumbar fractures.Methods A total of 120 patients with traumatic thoracolumbar fractures admitted to the hospital from February 2013 to February 2018 were randomly divided into control group and observation group,60 cases each.The control group underwent percutaneous balloon kyphoplasty(PKP)and the observation group underwent percutaneous vertebroplasty(PVP)combined with postural reduction.The clinical efficacy and perioperative index(VAS score,Cobb angle,vertebral body leading edge and posterior margin height)were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups(P>0.05).There was no significant difference in VAS score,Cobb angle and vertebral height between the two groups(P>0.05).There was no significant difference in VAS score and Cobb angle between the two groups after treatment(P>0.05).The heights of the anterior and posterior margins of the vertebral body were(28.31±4.47)mm and(32.64±4.53)mm,respectively,which were significantly higher than those of the control group(24.57±3.64)mm and(30.59±4.72)mm.The difference was statistically significant.(t=5.066,4.427,P<0.05).Conclusion The combination of PKP and PVP can effectively treat traumatic thoracolumbar fractures.PKP has better effect on restoring vertebral height.PVP has the advantages of wider indication,relatively simple operation and lower price.