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Open Access Article

International Journal of Clinical Research. 2024; 8: (9) ; 188-191 ; DOI: 10.12208/j.ijcr.20240388.

Clinical effect analysis of percutaneous vertebral kyphosis combined with manipulation maintenance reduction in the treatment of elderly patients with thoracic and lumbar compression fractures
经皮椎体后凸成形术中配合手法维持复位治疗骨质疏松胸腰椎压缩性骨折的临床疗效分析

作者: 温从游 *, 陈焕庆, 温喜乐

平阳县人民医院 浙江温州

*通讯作者: 温从游,单位:平阳县人民医院 浙江温州;

发布时间: 2024-09-28 总浏览量: 95

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

参考文献 References

[1] 邱贵兴, 裴福兴, 胡侦明, 等.中国骨质疏松性骨折诊疗指南 (骨质疏松性骨折诊断及治疗原则) [J].中华骨与关节外科杂志, 2015:371-374.

[2] Si L, Winzenberg TM, Jiang Q, et al. Projection of osteoporosis-related fractures and costs in China:2010-2050[J]. Osteoporos Int, 2015, 26:1929-1937.

[3] 吴泉,杜军,耿天勇,等.PKP和PVP治疗骨质疏松性椎体压缩骨折的疗效[J].临床骨科杂志,2019,22(3): 274-277.

[4] 黄志明,林川,熊涛,等.PKP治疗骨质疏松性胸腰椎压缩骨折[J].西南军医,2019,21(1):36-40.

[5] 王清泽,王相利,张金锋,等.椎体成形术与非手术治疗骨质疏松椎体压缩性骨折安全性的Meta分析[J].脊柱外科杂志, 2016,16(5):306-311.

[6] Hinde K, Maingard J, Hirsch JA, et al. Mortality outcomes of vertebral augmentation(vertebroplasty and/or balloon kyphoplasty) for osteoporotic vertebral compression fractures:a systematic review and meta-analysis[J]. Radiology, 2020,295(1):96-103.

[7] 金鹏, 孙钢.对经皮椎体强化术的再认识[J].介入放射学杂志, 2016, 25:463-468.

[8] 杨惠林, Yuan Hansen A, 陆俭, 等.球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩骨折[J].苏州大学学报:医学版, 2002, 22:406-409.

[9] 杨惠林,刘强,唐海.经皮椎体后凸成形术的规范化操作及相关问题的专家共识[J].中华医学杂志,2018,98(11):808-812.

[10] 戴勇,周思启,万波,等.经皮椎体后凸成形术治疗骨质疏松性脊柱压缩骨折[J].临床骨科杂志,2020,23(5): 644-646.

[11] Yang H, Liu T, Zhou J, et al. Kyphoplasty versus vertebroplasty for painful osteoporotic vertebral compression fractures-which one is better? A systematic review and meta-analysis[J]. Int J Spine Surg, 2013, 7:e45-e57.

[12] 蔡凯文,蒋国强,卢斌,等.椎间隙骨水泥渗漏的不同分型对邻椎相邻终板应力分布的影响:三维有限元研究[J].中华骨科杂志,2019,39(6):364-373.

[13] Sun K, Liu Y, Peng H, et al.A comparative study of high-viscosity cement percutaneous vertebroplasty vs.low-viscosity cement percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures[J].J Huazhong Univ Sci Technolog Med Sci, 2016, 36:389-394.

[14] Song D, Meng B, Gan M, et al.The incidence of secondary vertebral fracture of vertebral angmentation technique versus conserrative trentment for painfoul osteoporotic vertebral fractures:a systemation review and meta-analysis[J]. Acta Radiologica, 2015, 56:970-979.

引用本文

温从游, 陈焕庆, 温喜乐, 经皮椎体后凸成形术中配合手法维持复位治疗骨质疏松胸腰椎压缩性骨折的临床疗效分析[J]. 国际临床研究杂志, 2024; 8: (9) : 188-191.