目的:观察益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的临床疗效。方法:将152例老年骨质疏松性胸腰椎压缩骨折患者采用随机数字表法随机分为治疗组和对照组。对照组76例给予椎体成形术治疗。治疗组76例在对照组治疗基...目的:观察益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的临床疗效。方法:将152例老年骨质疏松性胸腰椎压缩骨折患者采用随机数字表法随机分为治疗组和对照组。对照组76例给予椎体成形术治疗。治疗组76例在对照组治疗基础上加服益肾补骨汤(葛根、黄芪、山药、淫羊藿、补骨脂、川续断、穿山甲、茯苓、鹿角霜、当归、熟地黄、红花)治疗,1 d 1剂,水煎药汁至200 mL,早晚温服。两组均于连续治疗2个月后判定疗效。结果:治疗组显效51例,有效22例,无效3例,有效率为96.06%;对照组显效36例,有效28例,无效12例,有效率为84.22%。两组疗效对比,差别有统计学意义(P<0.01)。治疗后,治疗组骨密度、Cobb角较对照组明显改善(P<0.01),功能障碍指数、VAS评分明显低于对照组(P<0.01)。结论:益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折可显著提高治疗效果,促进骨折愈合,有效缓解疼痛,值得推广运用。展开更多
Objective： To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures. Methods： Twenty patients who s...Objective： To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures. Methods： Twenty patients who suffered from nonadjacent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutaneous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and postoperative American Spinal Injury Association （ASIA） grades, fusion of fracture sites, visual analog scale （VAS） of back pain, and Oswestry disability index （ODD were accessed. Results： All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolumbar spine was restored satisfactorily. No patient had neurologic deterioration after surgery, and 9 patients with incom- plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions： Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advantages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thoracolumbar fractures.展开更多
文摘目的:观察益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的临床疗效。方法:将152例老年骨质疏松性胸腰椎压缩骨折患者采用随机数字表法随机分为治疗组和对照组。对照组76例给予椎体成形术治疗。治疗组76例在对照组治疗基础上加服益肾补骨汤(葛根、黄芪、山药、淫羊藿、补骨脂、川续断、穿山甲、茯苓、鹿角霜、当归、熟地黄、红花)治疗,1 d 1剂,水煎药汁至200 mL,早晚温服。两组均于连续治疗2个月后判定疗效。结果:治疗组显效51例,有效22例,无效3例,有效率为96.06%;对照组显效36例,有效28例,无效12例,有效率为84.22%。两组疗效对比,差别有统计学意义(P<0.01)。治疗后,治疗组骨密度、Cobb角较对照组明显改善(P<0.01),功能障碍指数、VAS评分明显低于对照组(P<0.01)。结论:益肾补骨汤联合椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折可显著提高治疗效果,促进骨折愈合,有效缓解疼痛,值得推广运用。
基金This work was supported by grants from the National Natural Science Foundation of China （No.30300357, 39830100） and National High Technology Development Foundation of China （863） （No.2003AA205021, 2006AA02Z4E3, 2006AA02A122）.
文摘Objective： To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures. Methods： Twenty patients who suffered from nonadjacent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutaneous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and postoperative American Spinal Injury Association （ASIA） grades, fusion of fracture sites, visual analog scale （VAS） of back pain, and Oswestry disability index （ODD were accessed. Results： All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolumbar spine was restored satisfactorily. No patient had neurologic deterioration after surgery, and 9 patients with incom- plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions： Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advantages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thoracolumbar fractures.
