体位复位结合两次球囊扩张椎体后凸成形术治疗老年性骨质疏松性胸腰椎骨折的临床疗效

Clinical Efficacy of Postural Repositioning Combined with Two Balloon-Expanded Vertebral Body Kyphoplasty for the Treatment of Elderly Osteoporotic Thoracolumbar Fractures

目的:探讨体位复位结合两次球囊扩张椎体后凸成形术治疗老年性骨质疏松性胸腰椎骨折的临床疗效。方法:选取2020年1月-2021年12月南京中医药大学常熟附属医院收治的行手术治疗的骨质疏松性胸腰椎骨折患者50例为观察对象,按照手术方法不同分为观察组和对照组,各25例。对照组行经皮穿刺球囊扩张后凸成形术治疗,观察组行体位复位结合两次球囊扩张椎体后凸成形术治疗,比较两组患者疼痛程度[视觉模拟评分法(VAS)],Oswestry功能障碍指数(ODI评分)、Cobb角,骨水泥渗漏、骨水泥注入量、手术时间。结果:术后2 d、术后2个月,两组患者VAS评分均降低,同时间点观察组低于对照组,差异有统计学意义(P<0.05);术后2 d,两组患者ODI评分、Cobb角均降低,观察组低于对照组,差异有统计学意义(P<0.05);观察组骨水泥渗漏发生率低于对照组,骨水泥注入量多于对照组,差异有统计学意义(P<0.05)。结论:体位复位结合两次球囊扩张椎体后凸成形术治疗老年性骨质疏松性胸腰椎骨折,可降低患者疼痛程度,能够降低骨水泥渗透率,加速骨折愈合,改善患者预后。

Objective:To investigate the clinical efficacy of postural repositioning combined with two balloon-expandable vertebral body kyphoplasty for the treatment of elderly osteoporotic thoracolumbar fractures.Methods:50 patients with osteoporotic thoracolumbar fractures who were treated surgically from January 2020 to December 2021 in Changshu Affiliated Hospital of Nanjing University of Traditional Chinese Medicine were selected as observation subjects,and were divided into observation group and control group according to different surgical methods,with 25 cases each.The control group was treated by percutaneous puncture balloon expansion kyphoplasty,while the observation group was treated by postural repositioning combined with two balloon-expandable vertebral body kyphoplasty.The pain level[visual analog scoring(VAS)],Oswestry dysfunction index(ODI score),Cobb's angle,cement leakage,cement injection volume,and operation time were compared between the two groups.Results:2 d after surgery and 2 months after surgery,VAS scores decreased in both groups,and the observation group was lower than the control group at the same time point.The difference was statistically significant(P<0.05).At 2 d postoperatively,ODI scores and Cobb angle were reduced in both groups,and the observation group was lower than the control group.The difference was statistically significant(P<0.05).The incidence of bone cement leakage in the observation group was lower than that in the control group,and the amount of bone cement injection was more than that in the control group,with statistically significant differences(P<0.05).Conclusion:Postural repositioning combined with two balloon-expandable vertebral body kyphoplasty for the treatment of elderly osteoporotic thoracolumbar fractures can reduce the pain level of patients,decrease the cement infiltration rate,accelerate fracture healing,and improve the prognosis of patients.