摘要
目的 探讨经皮椎体后凸成形术中配合手法维持复位治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法 选取2021年01月至2022年12月温州医科大学附属平阳人民医院收治的老年骨质疏松性胸腰椎压缩性骨折患者57例为研究对象，患者均采用经皮椎体后凸成形术中配合手法维持复位治疗，比较患者手术前后疼痛视觉模拟评分法（visual analogue scale，VAS）评分、ADL评分、伤椎椎体前缘高度、Cobb角（伤椎上下终板延长线的夹角）变化。结果 所有患者手术顺利完成，平均手术时间（34.33±10.56）min，骨水泥注入量（6.64±1.38）ml。随访 6～24个月，无症状复发病例。5例患者术中发生骨水泥渗漏。术后1d、末次随访患者的 VAS 评分、Cobb 角均显著低于术前（P<0.05），ADL评分、椎体前缘高度均显著高于术前（P<0.05）。结论 经皮椎体后凸成形术中配合手法维持复位治疗老年骨质疏松性胸腰椎压缩性骨折效果明显，术后患者疼痛明显缓解，椎体高度恢复良好，骨水泥渗漏率低，疗效满意。
关键词： 骨质疏松症、椎体骨折、手法复位、经皮椎体后凸成形术
Abstract
Objective To explore the clinical effect of percutaneous kyphosis in the treatment of thoracic and lumbar compression fractures in percutaneous kyphosis. Methods 57 elderly patients with osteoporotic thoracic and lumbar compression fractures admitted to Pingyang People's Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were selected as the subjects. All patients were treated with the reduction method of middle percutaneous vertebral posterior convexplasty to compare patients before and after surgery. Changes in visual analogue scale (VAS) scoring, ADL score, anterior edge height of the injured spine, Cobb angle (the angle of the upper and lower terminal extension line of the injured spine). Results The operation of all patients was successfully completed, with an average operating time (34.33±10.56) min and a bone cement injection volume (6.64±1.38) ml. Follow-up for 6 to 24 months, asymptomatic recurrence cases. Bone cement leakage occurred in 5 patients during surgery. The VAS score and Cobb angle of the postoperative 1d and last follow-up patients were significantly lower than that of the preoperative (P<0.05), and the ADL score and the height of the anterior edge of the vertebral were significantly higher than that of the preoperative (P<0.05). Conclusion The effect of percutaneous vertebral kyphosis and manipulation maintenance reduction in the treatment of elderly osteoporotic thoracic and lumbar compression fractures is obvious, the pain in postoperative patients is significantly relieved, the height of the vertebral body has recovered well, the bone cement leakage rate is low, and the curative effect is satisfactory.
Key words： osteoporosis, vertebral fracture, manipular reduction, percutaneous kyphosis
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