多气囊垫枕与手法复位结合椎体成形术治疗老年骨质疏松性椎体压缩骨折的疗效比较

Comparison of multi-balloon cushion and manual reduction combined with vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fractures

目的比较可调节多气囊垫枕与手法复位结合椎体成形术治疗老年骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)的近期临床疗效。方法回顾2019年1月至2021年2月期间在我院接受治疗的217例老年OVCF病人,根据治疗方式分为可调节多气囊垫枕组(A组,n=48)和手法复位结合椎体成形术组(B组,n=169),比较2组治疗前后VAS评分、Oswestry功能障碍指数(ODI评分)、椎体前缘高度压缩率以及恢复百分比,并比较2组并发症发生情况。结果2组病人基础资料、治疗前VAS评分、ODI评分、椎体前缘压缩率差异均无统计学意义(P>0.05)。治疗后3个月,2组VAS评分及ODI评分均低于治疗前,且B组低于A组(P<0.05);B组椎体前缘高度恢复率高于A组(P<0.05)。A组中1例出现下肢深静脉血栓,无骨折不愈合及再骨折发生。B组再骨折率为1.78%,骨水泥渗漏率为26.63%。结论对于老年人,可调节式多气囊垫枕是有效且安全可靠的保守方法,但手法复位结合椎体成形术临床疗效更佳,但需注意骨水泥渗漏等并发症。

Objective To compare the clinical efficacy of multi-balloon cushion and manual reduction combined with vertebroplasty in the treatment of the elderly patients with osteoporotic vertebral compression fractures(OVCF).Methods A total of 217 elderly patients with OVCF admitted in our hospital from January 2019 to February 2021 were divided into the adjustable multi-balloon cushion group(group A,n=48)and manual reduction combined with vertebroplasty group(group B,n=169).The visual analogue scale(VAS)score,Oswestry disability index(ODI),anterior vertebral body compression rate and recovery percentage were compared between the two groups before and after treatment.Results There were no statistical significances in the basic data,VAS score,ODI score and compression rate of anterior vertebral body between the two groups before treatment(P>0.05).The VAS score and ODI score in the two groups three months after treatment were all lower than those before treatment,especially in group B(P<0.05).The recovery rate of anterior vertebral body height in group B was higher than that in group A(P<0.05).In group A,lower extremity deep vein thrombosis occurred in 1 case,and no fracture nonunion and refracture were observed.The refracture rate in group B was 1.78%,and the bone cement leakage rate was 26.63%.Conclusions For elderly OVCF patients,the multi-balloon cushion is an effective,safe and reliable conservative method,but manual reduction combined with vertebroplasty is more effective,which is need to pay more attention to the complications,such as bone cement leakage.