单、双侧穿刺经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折对手术区域冠状面侧凸Cobb角的影响

发布时间：2018-01-12 04:02

本文关键词：单、双侧穿刺经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折对手术区域冠状面侧凸Cobb角的影响　出处：《中华临床医师杂志(电子版)》2016年22期 　论文类型：期刊论文

【摘要】：目的探讨单、双侧穿刺经皮椎体后凸成形术(PKP)治疗骨质疏松椎体压缩性骨折对手术区域冠状面侧凸Cobb角的影响。方法回顾性分析2010年1月至2014年6月在济宁医学院附属医院脊柱外科行PKP治疗的骨质疏松性椎体压缩性骨折的病例。采用随机对照研究,根据入院先后顺序,单数行单侧经皮穿刺球囊扩张椎体后凸成形术(单侧PKP患者40例),偶数行双侧经皮穿刺球囊扩张椎体后凸成形术(双侧PKP患者35例),同时抗骨质疏松药物治疗。收集患者一般资料:年龄、性别、骨折椎体数、骨折节段、腰痛时间,评估术前和术后疼痛视觉模拟量表(VAS)评分,Oswestry功能障碍指数(ODI),测量术前和术后手术区域冠状面侧凸Cobb角。统计两治疗组病例围手术期及术后随访的临床资料,分析对比两组间各项指标之间的差异是否具有相关性及统计学意义。结果两组一般资料比较差异无统计学意义(P0.05),75例患者均获得随访,随访12~36个月,平均24.6个月,VAS评分:两组组内术后末次随访与术后1周、术前,术后1周与术前比较差异均有统计学意义(P0.05),两组组间比较差异无统计学意义(P0.05);ODI:术后末次随访与本组术后1周、术前,术后1周与术前数据比较,两治疗组差异均有统计学意义(P0.05),末次随访两组组间比较差异有统计学意义(P0.05);冠状面侧凸Cobb角组内术后1周与术前、末次随访,术前与末次随访比较差异有统计学意义(P0.05),且两组组间末次随访比较差异有统计学意义(P0.05);术后1周、末次随访时双侧穿刺组冠状面侧凸Cobb角度纠正与ODI呈正相关(r=0.881,P0.05)。结论对于骨质疏松性椎体压缩性骨折患者,采用单侧或双侧经椎弓根行PKP的方法均可缓解疼痛,随着时间的延长,在纠正手术区域横断面侧凸畸形、ODI方面经双侧的方法疗效要优于单侧。
[Abstract]:Objective to study single. Percutaneous kyphoplasty with bilateral puncture. The effect of treatment of osteoporotic vertebral compression fracture on Cobb angle of coronal scoliosis in surgical area was analyzed retrospectively from January 2010 to June 2014 in the spinal surgery department of affiliated Hospital of Jining Medical College. Cases of osteoporotic vertebral compression fractures treated with KP. A randomized controlled study was used. According to the order of admission, unilateral percutaneous balloon kyphoplasty was performed in 40 patients with unilateral PKP. Bilateral percutaneous balloon kyphoplasty was performed in 35 patients with bilateral PKP. General data of patients were collected: age, sex, number of fracture vertebrae. Fracture segment, time of low back pain, preoperative and postoperative pain visual analogue scale (VAS) score and Oswestry dysfunction index (ODI) were evaluated. The Cobb angle of coronal scoliosis was measured before and after operation. The clinical data of perioperative period and postoperative follow-up were analyzed in both groups. Results there was no significant difference in general data between the two groups and 75 patients were followed up. Follow up 12 ~ 36 months, average 24.6 months and VAS score: the last follow-up and 1 week after operation in the two groups, preoperative, postoperative 1 week compared with the preoperative differences were statistically significant (P 0.05). There was no significant difference between the two groups (P 0.05). ODI: after the last follow-up and this group 1 week, preoperative, postoperative 1 week compared with the preoperative data, the two groups were statistically significant difference (P 0.05). There was significant difference between the two groups in the last follow-up (P 0.05). The Cobb angle of coronal scoliosis had a significant difference between 1 week after operation and 1 week after operation, the last follow-up, the preoperative follow-up and the last follow-up (P 0.05). There was a significant difference in the last follow-up between the two groups (P 0.05). The Cobb angle correction of coronary scoliosis in bilateral puncture group was positively correlated with ODI at 1 week and the last follow-up. Conclusion for patients with osteoporotic vertebral compression fracture, unilateral or bilateral transpedicular PKP can relieve the pain. The therapeutic effect of bilateral approach was better than that of unilateral method in correcting the transverse scoliosis deformity of surgical area.
【作者单位】：济宁医学院附属医院脊柱外科;济宁医学院;
【基金】：山东省医药卫生科技发展计划项目(2013WS0344,2015WS0412)
【分类号】：R687.3
【正文快照】： 骨质疏松椎体压缩性骨折(osteoporotic vertebralcompression fracture,OVCF)呈增多趋势,以胸腰段常见[1],已成为严重威胁中老年人健康的公共卫生问题。经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)因其可靠的疗效、优越的安全性、恢复一定的脊柱序列等优势而备受广大医

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