胸腰椎椎体成型术对老年骨质疏松性骨折的疗效分析

Therapeutic effect of thoracolumbar vertebral body surgery on senile osteoporotic fracture

目的对比双侧椎弓根穿刺椎体成形术与单侧椎弓根穿刺椎体成形术对老年骨质疏松性骨折的疗效。方法选择2017年3月至2019年2月在本院接受治疗的骨质疏松骨折患者96例进行研究。采用随机数字表法将患者分为两组,每组各48例。两组患者均由同1组具5年以上临床经验的医护人员根据患者情况行经皮椎体成形术治疗,对照组行单侧椎弓根穿刺椎体成形术,观察组则双侧椎弓根穿刺椎体成形术。对比两组患者手术一般情况、骨水泥渗漏率、疼痛、肢体功能及后凸矫正率。结果观察组患者手术时间、骨水泥注入量均明显大于对照组(P<0.05),两组骨水泥渗漏率差异无统计学意义。干预后两组患者VAS评分明显下降,JOA评分明显上升,但观察组下降或上升幅度均较大(P<0.05)。对照组后凸矫正率为(38.90±1.75)%与观察组的(40.13±2.09)%,差异无统计学意义。结论老年骨质疏松性骨折患者采用双侧椎弓根穿刺椎体成形术较单侧椎弓根穿刺椎体成形术可明显缓解疼痛、恢复肢体功能效果更佳。

Objective To compare the efficacy of bilateral pedicle puncture vertebroplasty and unilateral pedicle puncture vertebroplasty in elderly patients with osteoporotic fracture.Methods A total of 96 patients with osteoporotic fractures who were treated in our hospital from March 2017 to February 2019 were enrolled.Patients were divided into two groups using a random number table method,with 48 cases in each group.Two groups of patients were treated by percutaneous vertebroplasty according to the patient's condition in the same group of patients with more than 5 years of clinical experience.The control group underwent unilateral pedicle puncture vertebroplasty,and the observation group had bilateral pedicles.Puncture vertebroplasty.The general condition,cement leakage rate,pain,limb function and kyphosis correction rate were compared between the two groups.Results The operation time and bone cement injection volume of the observation group were significantly higher than those of the control group(P<0.05).There was no significant difference in the cement leakage rate between the two groups.After the intervention,the VAS scores of the two groups were significantly decreased,and the JOA scores were significantly increased,but the decline or increase of the observation group was larger(P<0.05).The kyphosis correction rate of the control group was(40.13±2.09)%compared with the observation group(38.90±1.75)%,and the difference was not statistically significant.Conclusion In patients with senile osteoporotic fractures,bilateral pedicle puncture vertebroplasty is more effective than unilateral pedicle puncture vertebroplasty in relieving pain and restoring limb function.