双侧可膨胀钛棘植入治疗预防老年骨质疏松性压缩骨折性骨折术后再骨折的临床研究

Clinical Study of Bilateral Expandable Titanium Spine Implantation in the Treatment of Senile Osteoporotic Compression Fracture

目的研究双侧可膨胀钛棘植入治疗预防老年骨质疏松性压缩骨折性骨折术后再骨折的手术技巧。方法本试验选取200例老年骨质疏松性压缩骨折患者,随机分为2组,试验组患者在骨折手术后植入双侧可膨胀钛棘,对照组患者则不采取该措施。分别对比观察患者二次骨折情况、VAS评分、术后1周和术后1-2年腰椎骨密度变化以及治疗前后特异性生存质量量表评分变化,同时分析骨质疏松性骨折患者术后再发骨折的危险因素。结果两组患者二次骨折情况、术后1年和2年腰椎骨密度值以及治疗后特异性生存质量量表评分间均有统计学差异(P<0.01),而在术后1周的腰椎骨密度和术后5-12周的二次骨折情况间无统计学差异(P>0.05)。BMI(>24和<24)、年龄、VAS评分和Barthel评分是骨质疏松性骨折患者术后再发骨折的主要危险因素,BMI>24时,再发骨折率相对较高,发生再次骨折的患者平均年龄为(72.39±3.12),VAS评分相对较高,而Barthel评分则较低。结论双侧可膨胀钛棘植入治疗预防老年骨质疏松性压缩骨折性骨折术后再骨折,值得临床广泛推广。

Objective To study the surgical technique of bilateral expandable titanium spine implantation for prevention of re-fracture after osteoporotic compression fracture in the elderly.Methods In this study,200 cases of elderly patients with osteoporotic compression fracture were selected and divided into two groups on average.Among them,patients in the experimental group received bilateral expansion of titanium spine after fracture surgery,while patients in the control group did not take this measure.The secondary fracture situation,VAS score,lumbar vertebral bone density change 1 week after surgery and 1-2 years after surgery,as well as the specific quality of life scale score change before and after treatment were compared and observed respectively.Meanwhile,risk factors of recurrent fracture in patients with osteoporotic fracture were analyzed.Results There were significant differences between the two groups in secondary fracture,lumbar vertebral bone density at 1 and 2 years after surgery,and specific quality of life scale score after treatment(P<0.01),while there were no significant differences between lumbar vertebral bone density at 1 week after surgery and secondary fracture at 5-12 weeks after surgery(P>0.05).BMI(>24 and<24),age,VAS score and Barthel score were the main risk factors for recurrent fractures in patients with osteoporotic fractures.The rate of recurrent fractures was relatively high at BMI>24,and the average age of patients with recurrent fractures was(72.39±3.12).VAS score was relatively high,while Barthel score was relatively low.Conclusion Bilateral inflatable titanium spine implantation for prevention of re-fracture after osteoporotic compression fracture in the elderly is worthy of extensive clinical promotion.