过伸牵引弹性按压联合椎后垫枕在OVCF患者PVP术前的应用效果观察

Effect of Applying Hyperextension Traction Elastic Pressure and Bolster under the Vertebrae before PVP Operation for OVCF

目的探究骨质疏松性椎体压缩性骨折(OVCF)患者经皮椎体成形术(PVP)前应用过伸牵引弹性按压联合椎后垫枕治疗的临床效果。方法选取2019年3月至2019年9月嵩县西关骨科医院收治的86例OVCF患者作为研究对象,按照随机数表法将其随机分为联合组(43例)与对照组(43例),联合组患者在PVP治疗前行过伸牵引弹性按压联合椎后垫枕治疗,对照组患者单纯采用PVP治疗,对比观察两组患者手术相关情况、疼痛程度、椎体和下肢功能恢复情况以及并发症发生情况。结果两组患者手术时间无明显差异(t=0.433,P=0.666);联合组患者手术至下床活动时间及住院时间明显短于对照组,术后5 d数字分级评分法(NRS)评分明显低于对照组,术后6个月椎体高度明显高于对照组、后凸Cobb角明显小于对照组、Fugl⁃Meyer运动功能评定量表下肢部分(FMA⁃LE)评分明显高于对照组(t=4.833、5.152、4.506、2.945、7.858、6.889,P<0.001、P<0.001、P<0.001、P=0.004、P<0.001、P<0.001);术后随访6个月,联合组患者出现腰背疼痛2例,并发症发生率为4.65%,与对照组患者出现的腰背疼痛2例、邻近椎体骨折2例,并发症发生率9.30%无明显差异(χ^(2)=0.717,P=0.397)。结论PVP治疗前行过伸牵引弹性按压联合椎后垫枕治疗,可促进OVCF患者术后康复,减轻患者疼痛程度,最大限度恢复椎体解剖结构。

Objective To investigate the application effect of hyperextension traction elastic pressure and bolster under the vertebrae before percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fracture(OVCF).Methods 86 OVCF patients,admitted into Songxian Xiguan Orthopaedic Hospital from March 2019 to Septem⁃ber 2019,were enrolled as research subjects and divided,using the random number table,into combination group(n=43)and control group(n=43).Patients in combination group underwent hyperextension traction elastic pressure combined with bolster under the vertebrae before PVP treatment,whereas patients in control group received PVP treatment alone.The surgery⁃related indexes,pain degree,functional recovery of vertebral body and lower extremities,and occurrence of compli⁃cations were compared between the two groups.Results There was no significant difference between the two groups in terms of operation duration(t=0.433,P=0.666).However,compared with control group,the time from operation to off⁃bed ambulation and length of stay of patients in combination group were significantly shorter(t=4.833 and 5.152,both P<0.001),the numerical rating scale(NRS)score on day 5 after surgery was markedly higher(t=4.506,P<0.001),and at six months after surgery the vertebral height was significantly higher(t=2.945,P=0.004),the kyphosis Cobb angle was obviously smaller(t=7.858,P<0.001)and the Fugl⁃Meyer assessment of lower extremity(FMA⁃LE)score was markedly higher(t=6.889,P<0.001).During the follow⁃up six months after surgery,2 cases suffered from back pain in combination group,with the incidence of complications being 4.65%,while in control group 2 cases suffered from back pain,and 2 cases developed fractures of adjacent vertebral bodies,with the incidence of complications being 9.30%,between which no significant difference was observed(χ^(2)=0.717,P=0.397).Conclusion The application of hyperex⁃tension traction elastic pressure and bolster under the vertebrae in OVCF patients before PVP treatment can accelerate their postoperative rehabilitation,alleviate pain,and restore anatomic structures of vertebral bodies maximally.