经皮微创截骨矫形骨水泥灌注治疗老年陈旧性胸腰椎骨折的应用

Percutaneous minimally invasive osteotomy and orthopedic bone cement perfusion in the treatment of old thoracolumbar fractures

目的分析并评估老年骨质疏松性胸腰椎骨折行微创截骨矫形骨水泥灌注手术的安全性和有效性。方法回顾性分析2015年1月至2019年6月解放军东部战区海军医院收治的老年陈旧性胸腰椎骨折51例患者的临床资料,其中采用微创截骨矫形骨水泥灌注治疗21例(微创组),药物保守治疗30例(保守组)。比较2组患者治疗前及治疗后1个月、3个月、6个月及12个月时的VAS评分、Oswestry功能障碍评分(ODI评分),治疗前及治疗后1个月、12个月随访时的椎体前后缘高度百分比及患者的满意度评分。结果所有患者均完成12个月以上随访,平均随访14.8个月。微创组出现1例轻度骨水泥渗漏、未出现神经症状。微创组治疗后1个月、3个月、6个月及12个月随访时的VAS评分、ODI评分,以及治疗后1个月、12个月随访时的椎体前后缘高度百分比均显著优于保守组(P<0.01),患者治疗的满意度评分亦高于保守组[(88.27±5.11)分vs(65.35±3.71)分,P<0.01]。结论采用微创截骨矫形骨水泥灌注治疗老年陈旧性胸腰椎骨折,可以有效改善患者的临床症状,提高生活质量,具有相对的安全性和有效性,可作为临床治疗的选择方案之一。

Objective To analyze and evaluate the safety and effectiveness of minimally invasive osteotomy and orthopedic bone cement infusion for elderly osteoporosis thoracolumbar fractures.Methods A retrospective analysis of the clinical data of 51 elderly patients with old thoracolumbar fractures admitted to the Naval Hospital of the Eastern Theater of the People’s Liberation Army from January 2015 to June 2019.Among them,21 cases were treated with minimally invasive osteotomy and orthopedic bone cement perfusion(minimally invasive group),30 cases were treated conservatively with drugs(conservative group).Compare the VAS scores,Oswestry dysfunction score(ODI score)before treatment and 1 month,3 months,6 months and 12 months after treatment,before treatment and 1 month and 12 months after treatment The percentage of the height of the anterior and posterior edge of the vertebral body at the follow-up and the patient’s satisfaction score.Results All patients completed follow-up of more than 12 months,with an average follow-up of 14.8 months.In the minimally invasive group,there was 1 case of mild bone cement leakage and no neurological symptoms.In the minimally invasive group,the VAS scores and ODI scores at 1 month,3 months,6 months,and 12 months follow-up after treatment,and the anterior and posterior vertebral height percentages at 1 month and 12 months after treatment were all significant It is better than the conservative group(P<0.01),and the satisfaction score of patients with treatment is also higher than that of the conservative group[(88.27±5.11)points vs(65.35±3.71)points,P<0.01].Conclusion The use of minimally invasive osteotomy and orthopedic bone cement perfusion for the treatment of old thoracolumbar fractures in the elderly can effectively improve the clinical symptoms of patients and improve the quality of life.It has relative safety and effectiveness and can be invoked as one of the options for clinical treatment.