骨水泥内固定术式治疗老年性多节段压缩骨折疗效观察

Clinical effect of internal fixation with bone cement in the treatment of elderly patients with multi-segmental compression fractures

目的观察骨水泥内固定术式治疗老年性多节段压缩骨折(MSCF)患者的临床疗效。方法选择2007年1月至2015年1月在新疆生产建设兵团医院治疗的128例老年性MSCF患者作为观察组,另选同期在医院接受保守治疗的125例老年性MSCF患者作为对照组。对照组给予保守治疗,观察组给予骨水泥内固定术治疗,治疗后随访6个月,比较两组患者不同时期的疗效及随访预后。结果治疗后经6个月随访,观察组患者的Oswestry功能障碍指数(ODI)为(43.27±14.23)%,Cobb角为(13.85±3.42)°,明显低于对照组的(48.33±14.97)%及(28.64±3.82)°,Barthel指数为(83.79±5.78),明显高于对照组的(80.23±6.25),差异均有统计学意义(P<0.05)。观察组治疗后3个月及6个月的VAS评分分别为(2.41±1.31)分、(2.43±1.18)分,均明显低于对照组的(2.84±1.70)分、(2.71±1.03)分,差异有统计学意义(P<0.05)。观察组患者的椎体变形、压缩,治疗后再骨折及椎体高度未获良好保持的发生率分别为7.81%、5.47%及3.13%,分别与对照组的4.80%、2.40%及4.00%比较,差异均无统计学意义(P>0.05)。结论骨水泥内固定术式治疗老年性MSCF患者疗效较好,安全性较高,值得临床推广应用。

Objective To observe the effect of internal fixation with bone cement in the treatment of elderly patients with multi-segmental compression fractures(MSCF). Methods One hundred and twenty-eight MSCF patients treated by internal fixation with bone cement in Xinjiang Production and Construction Corps Hospital from January2007 to January 2015 were selected as the observation group, and 125 MSCF patients received conservative treatment were selected as the control group. All the patients were followed up for 6 months after treatment. The efficacy and prognosis of patients in different periods were compared between the two groups. Results After 6 months of treatment, the Oswestry disability index(ODI), Cobb angle, Barthel index in the observation group were(43.27±14.23)%,(13.85 ± 3.42)°,(83.79 ± 5.78), respectively, which showed statistically significant difference with those of the control group of(48.33 ± 14.97)%,(28.64 ± 3.82)°,(80.23 ± 6.25), P<0.05. The VAS scores at 3 and 6 months after treatment were(2.41±1.31),(2.43±1.18) in the observation group, which were significantly lower than those of the control group of(2.84±1.70),(2.71±1.03), and the differences were statistically significant(P<0.05). The incidences of vertebral deformation, compression, fracture after treatment, as well as the incidence of vertebral height was 7.81%, 5.47% and 3.13% respectively, which showed no statistically significant difference with 4.80%, 2.40% and 4.00% in the control group(P>0.05).Conclusion Internal fixation with bone cement is effective in the treatment of elderly patients with multi-segmental compression fracture, with high efficacy and good safety, which is worth clinical promotion and application.