手术床反折V型复位联合PVP治疗伴椎体后壁骨折OVCF患者的效果

Effect of Folded Operating Bed V-shaped Reduction Combined with PVP in the Treatment of OVCF Patients with Vertebral Posterior Wall Fracture

目的:探讨手术床反折V型复位联合PVP治疗伴椎体后壁骨折骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者的效果。方法:回顾性选取2019年3月—2021年6月徐州医科大学第二附属医院行手术床反折V型复位联合PVP治疗的56例OVCF患者。根据椎体后壁是否骨折将其分为研究组和对照组,各28例。两组均给予手术床反折V型复位联合PVP治疗。比较两组围手术期指标及骨水泥渗漏率,术前及术后2 d、术后3个月的视觉模拟量表(VAS)评分、伤椎前缘高度比及Cobb角。分析典型病例。结果:研究组术中透视次数多于对照组,差异有统计学意义(P<0.05)。两组手术时间、骨水泥量比较差异无统计学意义(P>0.05)。研究组骨水泥渗漏率(25.0%)稍高于对照组(17.9%),但差异无统计学意义(P>0.05)。两组术前,术后2 d及术后3个月VAS评分、伤椎前缘高度比及Cobb角比较差异无统计学意义(P>0.05)。与术前相比,两组术后2 d及术后3个月VAS评分、Cobb角降低,伤椎前缘高度比升高,差异有统计学意义(P<0.05)。两组术后2 d和术后3个月VAS评分、Cobb角、伤椎前缘高度比比较差异无统计学意义(P>0.05)。结论:手术床反折V型复位联合PVP治疗伴椎体后壁骨折的OVCF安全有效,能缓解疼痛,恢复椎体高度及后凸角,并未增加骨水泥渗漏风险。

Objective:To evaluate the effect of folded operating bed V-shaped reduction combined with PVP in the treatment of osteoporotic vertebral compression fracture(OVCF)patients with vertebral posterior wall fracture.Method:A total of 56 patients with OVCF who underwent folded operating bed V-shaped reduction combined with PVP treatment in the Second Affiliated Hospital of Xuzhou Medical University from March 2019 to June 2021 were retrospectively selected.They were divided into study group and control group according to whether the posterior wall of vertebral body was fractured,28 cases in each group.Both groups were treated with folded operating bed V-shaped reduction combined with PVP.The perioperative indexes and bone cement leakage rate,visual analogue scale(VAS)score,anterior edge height rate of injured vertebra and Cobb angle before operation and 2 days and 3 months after operation were compared between the two groups.The typical cases was analyzed.Result:The number of intraoperative fluoroscopy in the study group was more than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in operation time and bone cement volume between the two groups(P>0.05).The leakage rate of bone cement in the study group(25.0%)was slightly higher than that in the control group(17.9%),but the difference was not statistically significant(P>0.05).There were no significant differences in VAS score,anterior edge height rate of injured vertebra,and Cobb angle between the two groups before operation,at 2 days and 3 months after operation(P>0.05).Compared with before operation,the VAS score and Cobb angle of the two groups were decreased at 2 days and 3 months after operation,and the height rate of the anterior edge of the injured vertebra was increased,and the differences were statistically significant(P<0.05).There were no significant differences in VAS score,Cobb angle,and anterior edge height rate of injured vertebra between the two groups at 2 days and 3 months after operation(P>0.05).Conclusion:Operating bed V-shaped reduction combined with PVP is safe and effective in the treatment of OVCF with vertebral posterior wall fracture.Which can relieve pain,improve vertebral height and Cobb angle,without increasing the risk of bone cement leakage.