骨水泥强化椎弓根螺钉固定治疗骨质疏松性胸腰椎骨折的效果及对患者生存质量的影响

Effect of cement reinforced pedicle screw fixation in the treatment of osteoporotic thoracolumbar vertebrae fracture and its effect on quality of life

目的探讨骨水泥强化椎弓根螺钉固定治疗骨质疏松性胸腰椎骨折的疗效及对患者生存质量的影响。方法选取2015年4月至2017年6月山西省煤炭中心医院收治的骨质疏松性胸腰椎骨折患者60例为研究对象,依据治疗方式不同予以分组,每组30例。对照组予经皮穿刺椎体成形术,观察组予骨水泥强化椎弓根螺钉固定治疗。统计并比较两组患者术前和术后6个月健康和功能评分、生活满意度评分、社会经济因素评分、自我概念评分、视觉模拟评分法(VAS)评分、Cobb角。结果观察组患者术后6个月健康和功能评分、生活满意度评分、社会经济因素评分、自我概念评分[(60.2±6.0)分、(39.8±4.0)分、(32.0±3.5)分、(47.7±4.0)分]均高于对照组[(48.0±5.5)分、(32.4±3.0)分、(29.3±2.0)分、(44.0±3.3)分],差异均有统计学意义(t=8.989、8.106、3.668、3.908,均P<0.05);观察组患者术后6个月VAS评分[(1.5±0.4)分]低于对照组[(2.3±0.8)分],差异有统计学意义(t=4.898,P<0.05);观察组患者术后6个月Cobb角[(5.3±1.0)°]低于对照组[(14.0±2.2)°],差异有统计学意义(t=19.718,P<0.05)。结论对骨质疏松性胸腰椎骨折患者实施骨水泥强化椎弓根螺钉固定治疗临床效果显著,并可明显改善患者生存质量。

Objective To observe and evaluate the clinical effect of cement reinforced pedicle screw fixation in the treatment of osteoporotic thoracolumbar fractures and its effect on the quality of life. Methods From April 2015 to June 2017, 60 patients with osteoporotic thoracolumbar fractures were selected from Shanxi Coal Center Hospital.The patients were divided into two groups according to different treatment method, with 30 cases in each group.Routine percutaneous vertebroplasty was performed in the control group, and bone cement reinforced pedicle screw fixation was performed in the observation group.The scores of health and function, life satisfaction score, the scores of social and economic factors, self-concept score, visual analogue scale (VAS) and Cobb's angle were calculated and evaluated before operation and 6 months after operation in the two groups. Results The scores of health and function, life satisfaction, social and economic factors, self-concept in the observation group at 6 months after operation were (60.2±6.0)points,(39.8±4.0)points,(32.0±3.5)points,(47.7±4.0)points, respectively, which were significantly higher than those in the control group[(48.0±5.5)points,(32.4±3.0)points,(29.3±2.0)points,(44.0±3.3)points], the differences were statistically significant (t=8.988.106, 3.668, 3.908, all P<0.05). The VAS score in the observation group was significantly lower than that in the control group at 6 months after operation[(1.5±0.4)points vs.(2.3±0.8)points](t=4.898, P<0.05). The Cobb angle of the observation group[(5.3±1.0)°] was significantly lower than that of the control group[(14.0±2.2)°] at 6 months after operation (t=19.718, P<0.05). Conclusion Treatment of osteoporotic thoracolumbar vertebrae fracture with bone cement reinforced pedicle screw fixation has better clinical effect and can obviously improve the quality of life.