摘要
目的探讨在体位复位下经皮椎体成形术(PVP)治疗老年骨质疏松性椎体压缩骨折的近期临床疗效。方法体位复位下经皮穿刺单侧椎弓根入路治疗胸腰段骨折31例,对手术前后的疼痛视觉模拟评分(VAS)、Cobb角及活动能力评分(LAS)进行比较。结果 31例患者术后腰背部疼痛明显缓解或消失,VAS术前为(8.27±0.57)分,术后1 d为(1.80±0.78)分,术后6个月为(1.37±0.61)分(P<0.05);术后后凸畸形得到部分矫正,Cobb角术前为25°±4.4°,术后1 d为13°±3.1°,术后6个月为14°±3.2°(P<0.05);术后恢复日常活动,LAS术前为(3.4±0.5)分,术后1 d为(1.3±0.2)分,术后6个月为(1.2±0.1)分(P<0.05)。有3例骨水泥渗漏,未发生严重并发症。31例均获随访,时间6～24个月,疼痛及骨折无再发。结论 PVP结合体位复位是治疗新鲜的老年骨质疏松性胸腰段单椎体压缩骨折的有效微创技术,操作简便,能够迅速缓解疼痛,改善功能,部分矫正后凸畸形。
Objective To assess short-term efficacy of the combination of postural reduction and percutaneous vertebroplasty(PVP) in the treatment of compression fracture of vertebra in elderly patients with osteoporosis.Methods Under the combination of postural reduction and PVP,31 aged patients with compression fracture of thoracolumbar vertebra were reviewed via unilateral pedicle percutaneous puncture,the clinical effects were evaluated by observing the charges of visual analogue scale(VAS),the Cobb angle and locomotor activity scale(LAS).Results Low back pain disappeared or relieved obviously in all 31 cases postoperatively.VAS and LAS were reduced from a mean preoperative score of 8.27±0.57 and 3.4±0.5 to a mean postoperative score of 1.80±0.78 and 1.3±0.2 the first day after operation standing position or 1.37±0.61 and 1.2±0.1 six months afterward respectively(P<0.05).The Cobb angle was improved from 25°±4.4° preoperatively to 13°±3.1° or 14°±3.2°,the first day and six months after operation standing position afterward respectively(P<0.05).There were three cases got bone cement leakage,no complications were found.The duration of the follow-up was 6~24 months.There were no relapse of low back pain and vertebra fracture during the follow-up.Conclusions The combination of percutaneous vertebroplasty(PVP) and postural reduction is an effective kind of minimally invasive surgery in treating single section of the fresh thoracolumbar vertebral compressive fracture in aged patients with osteoporosis.It is simple in relieving pain,recovering function and correcting kyphosis.
出处
《临床骨科杂志》
2011年第6期636-638,共3页
Journal of Clinical Orthopaedics
关键词
椎体成形术
单侧椎弓根
骨质疏松
胸腰椎骨折
体位复位
vertebroplasty
unilateral pedicle
osteoporosis
thoracolumbar vertebral fractures
postural reduction
