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经皮椎弓根钉内固定联合椎体成形术治疗单椎体骨质疏松性脊柱压缩骨折的临床效果(1)
http://www.100md.com 2018年10月5日 《中国当代医药》 2018年第28期
     [摘要]目的 探讨经皮椎弓根钉内固定联合椎体成形术治疗单椎体骨质疏松性脊柱压缩骨折的临床效果。方法 选取2016年3月~2017年3月我院收治的60例骨质疏松性脊柱压缩骨折患者作为研究对象,根据信封随机分组法分为对照组和观察组,每组各30例。对照组患者给予单纯椎体成形术治疗,观察组患者给予经皮椎弓根螺钉内固定联合椎体成形术治疗,比较两组患者的临床效果。结果 观察组患者的优良率、Barthel评分、椎体高度恢复率高于对照组,Oswestry评分、VAS评分、并发症发生率、椎体高度压缩率均低于对照组,椎体后凸角小于对照组(P<0.05)。结论 经皮椎弓根螺钉内固定结合椎体成形术治疗骨质疏松性脊柱压缩骨折患者的效果显著。

    [关键词]单椎体骨质疏松性脊柱骨折;單纯椎体成形术;经皮椎弓根内固定结合椎体成形术;临床疗效比较

    [中图分类号] R687.3 [文献标识码] A [文章编号] 1674-4721(2018)10(a)-0091-03

    [Abstract] Objective To explore the clinical effect of percutaneous pedicle screw fixation combined with vertebroplasty in the treatment of osteoporotic spinal compression fractures of single vertebral body. Methods Sixty patients with osteoporotic spinal fractures treated in our hospital from March 2016 to March 2017 were selected as study subjects. According to the method of randomization of envelopes, they were divided into control group and observation group, with 30 cases in each group. The patients in the control group were treated with vertebroplasty alone. The observation group was treated with percutaneous pedicle screw fixation combined with vertebroplasty. The clinical effects of the two groups were compared. Results In the observation group, the excellent and good rate, Barthel score, vertebral body height recovery rate were higher than those in the control group, the Oswestry score, the VAS score, complication rate, vertebral body height compression rate were lower than those in the control group, and kyphosis angle was less than that in the control group (P<0.05). Conclusion Percutaneous pedicle screw fixation combined with vertebroplasty is effective in the treatment of patients with osteoporotic spinal fractures.

    [Key words] Single vertebral osteoporotic spine fractures; Vertebroplasty alone; Percutaneous pedicle screw fixation combined with vertebroplasty; Clinical efficacy comparison

    随着老龄化社会的到来,骨质疏松症发生率呈上升趋势,且经研究统计,女性发生率高于男性,且具有发生率高、病程长、病情反复等特点[1],大部分患者均存在慢性疼痛、生活质量下降、活动受限、畸形、椎体高度丢失,干预不及时,可危及患者生命安全。为了控制病情,还需加强手术治疗,其能够缓解脊柱疼痛感,恢复原本高度,改善患者的生活质量,但随着相关报道增多,发现不同的手术技巧可达到不同的治疗效果[2]。本文旨在探讨不同治疗方式在单椎体骨质疏松性脊柱压缩骨折患者中的价值,现报道如下。

    1资料与方法

    1.1 一般资料

    选取2016年3月~2017年3月我院收治的60例骨质疏松性脊柱压缩骨折患者作为研究对象,根据信封随机分组法分为两组,每组各30例。观察组男19例,女11例;年龄51~79岁,平均(68.95±2.11)岁;病程6~24个月,平均(12.35±2.61)个月;受损部位:腰椎骨折20例,胸椎骨折10例;椎体受累情况:3例受累T11,7例受累T12,12例受累L1,8例受累L2。对照组男20例,女10例;年龄52~80岁,平均(68.61±2.53)岁;病程7~28个月,平均(12.96±2.54)个月;受损部位:腰椎骨折18例,胸椎骨折12例;椎体受累情况:2例受累T11,8例受累T12,13例受累L1,7例受累L2。两组患者的一般资料比较,差异无统计学意义(P>0.05),具有可比性。本研究已经医院医学伦理委员会批准。, http://www.100md.com(钟鸣亮 郭朝阳 陈勤)
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