二次手术和保守治疗对椎体压缩性骨折PKP术后非手术椎体再发骨折的临床研究

Clinical Study of Secondary Surgery and Conservative Treatment on Non-surgical Vertebral Recurrent Fractures after PKP for Vertebral Compression Fractures

目的探究二次手术和保守治疗对椎体压缩性骨折PKP术后非手术椎体再发骨折的临床研究。方法随机选取本院2017年1月-2018年9月骨科收治的患者52例。采用随机数字表法将其分为保守组和手术组,各26例。保守组对再发骨折患者行保守治疗,包括功能锻炼、卧床休息、佩戴护具、抗骨质疏松治疗。手术组对再发骨折患者进行第二次PKP手术。比较两组患者治疗前后VAS疼痛评分、中柱椎体高度、Cobb角与临床疗效。结果治疗后,手术组VAS疼痛评分低于保守组,差异有统计学意义(P<0.05);手术组中柱椎体高度高于保守组,Cobb角低于保守组,差异有统计学意义(P<0.05);手术组总有效率高于保守组,差异有统计学意义(P<0.05)。结论对椎体压缩性骨折PKP术后非手术椎体再发骨折患者行二次手术,可减轻患者疼痛,改善患者中柱椎体高度与Cobb角,促进患者恢复,疗效佳,值得临床推广。

Objective To investigatesecondary surgery and conservative treatment on non-surgical vertebral recurrent fractures after percutaneouskyphoplasty(PKP)for vertebral compression fractures.Methods 104 patients admitted to the orthopedic department of our hospital from January 2017 to September 2018 were randomly selected,and were divided into conservative group and operation group,each with 52 cases.The conservative group received conservative treatment,including functional exercise,bed rest,wearing protective equipment and analgesic drugs.The operation group underwent the second PKP surgery.The VAS score,middle vertebral column height,Cobb angle and clinical efficacy were compared before and after treatment.Results After treatment,the VAS score of the operation group was lower than that of the conservative group(P<0.05).The vertebral height and Cobb Angle in the operation group were significantly higher than those in the conservative group(P<0.05).The total effective rate of the operation group was significantly higher than that of the conservative group(P<0.05).Conclusion The secondary surgery of non-surgical vertebral recurrent fractures after PKP for vertebral compression fractures can alleviate the pain,improve the height of vertebral body and Cobb angle,and promote the recovery,which is worthy of clinical promotion.