两种手术方式治疗老年胸腰椎压缩性骨折效果比较

Comparision of two surgeries in the treatment of senile thoracolumbar compression fractures

目的比较切开复位内固定和经皮穿刺球囊括张椎体成型术治疗老年性胸腰椎压缩性骨折的效果。方法选取老年性胸腰椎压缩性骨折患者152例为研究对象,按随机投掷法分为对照组和研究组。对照组实施切开复位内固定手术,研究组实施经皮穿刺球囊扩张椎体成型术治疗。比较2组手术时间、术中出血量、首次下床时间,统计2组手术效果、治疗前后椎体高度、Cobb角、视觉模拟评分法(VAS)评分及并发症发生情况。结果研究组手术时间、首次下床时间短于对照组,术中出血量少于对照组,差异有统计学意义(P <0.05);研究组治疗总有效率为96.05%,高于对照组的84.21%,差异有统计学意义(P <0.05);治疗后第3个月,研究组椎体高度大于对照组,Cobb角小于对照组,VAS评分低于对照组,差异有统计学意义(P <0.05);研究组并发症发生率为10.53%,低于对照组的25.00%,差异有统计学意义(P <0.05)。结论经皮穿刺球囊扩张椎体成型术治疗老年性胸腰椎压缩性骨折的效果显著,且并发症少。

Objective To compare effect of open reduction and internal fixation as well as percutaneous balloon dilatation vertebroplasty in the treatment of senile thoracolumbar compression fractures.Methods A total of 152 patients with senile thoracolumbar compression fractures were selected as research objects,and were divided into control group and study group according to random throwing method.The control group performed open reduction and internal fixation,and the study group performed percutaneous balloon dilatation vertebroplasty.The operation time,intraoperative blood loss,and time to first getting out of bed,surgical efficacy,vertebral body height,Cobb angle,Visual Analogue Scale(VAS)score and complications were compared between the two groups.Results The operation time and time to first getting out of bed in the study group were significantly shorter,and the intraoperative blood loss was significantly less than that in the control group(P<0.05);the total effective rate in the study group was 96.05%,which was significantly higher than 84.21%in the control group(P<0.05).At 3 months after treatment,the vertebral body height in the study group was significantly greater,and the Cobb angle was significantly smaller,and the VAS score was significantly lower han than that in the control group(P<0.05);the complication rate of the study group was 10.53%,which was significantly lower than 25.00%of the control group(P<0.05).Conclusion Percutaneous balloon dilatation vertebroplasty is effective in treating senile compression fractures of the thoracolumbar vertebrae and has fewer complications.