探究压缩骨折Denis分型对不同椎体成形术恢复椎体高度、改善局部后凸cobb角疗效的影响

发布时间：2018-04-15 07:27

本文选题：压缩骨折Denis分型 + 椎体高度　；参考：《山东中医药大学》2017年硕士论文

【摘要】：目的:探究压缩骨折Denis分型对不同椎体成形术恢复椎体高度、改善局部后凸cobb角疗效的影响。方法:回顾性分析2015年4月~2016年1月间于我院脊柱骨科经三种不同椎体成型手术治疗与随访的骨质疏松性压缩骨折的病例174例,从中筛选出124例病例并分组,对此病例资料进行Nakai腰痛手术疗效分级、椎体高度恢复率及改善局部后凸cobb角的疗效评价。结果:分析比较PVP、PKP、Vesselplasty术后Nakai腰痛疗效分级,三者无统计学差异(p0.05);胸腰椎骨质疏松性压缩骨折的Denis分型对PVP组、PKP组和Vesselplasty组在恢复椎体高度,改善胸腰椎局部后凸Cobb角,纠正胸腰椎局部后凸畸形的疗效影响,其差异存在统计学意义(p0.05)。PKP组与Vesselplasty组在对患者椎体高度恢复、改善胸腰椎局部后凸Cobb角,纠正胸腰椎局部后凸畸形上与PVP组对比有显著差异,而两组间对比无明显差异(p0.05);压缩骨折Denis分型中A型组经椎体成形术治疗后恢复椎体高度,改善胸腰椎局部后凸Cobb与其他组比较效果差,有统计学差异(P0.05),B型组、D型组在恢复椎体高度,胸腰椎局部后凸Cobb改善中效果较好。结论:1.椎体成形术PVP、PKP、Vesselplasty在治疗胸腰椎体骨质疏松性压缩骨折缓解胸腰背部疼痛临床疗效显著。2.PKP、Vesselplasty在对椎体高度恢复、胸腰椎局部后凸Cobb角改善,纠正胸腰椎局部后凸畸形方面较PVP手术效果好。3.椎体成形术在治疗OVCF压缩骨折Denis分型中B型、D型在椎体高度恢复方面比A型、C型效果好,C型次之,A型最差。4.椎体成形术在治疗OVCF压缩骨折Denis分型中D型在改善胸腰椎局部后凸Cobb角方面最好,B型稍次之,C型次之,A型最差。5.压缩骨折Denis分型对指导选择不同椎体成形术治疗胸腰椎骨质疏松性压缩骨折在椎体高度恢复、胸腰椎局部后凸Cobb角改善,纠正胸腰椎局部后凸畸形方面具有一定临床意义。
[Abstract]:Objective: to investigate the effect of Denis classification of compression fracture on restoring vertebral height and improving cobb angle of local kyphosis.Methods: from April 2015 to January 2016, 174 cases of osteoporotic compression fractures were treated and followed up by three different vertebrae orthopaedics in our hospital. 124 cases were selected and divided into two groups.The clinical data of this case were evaluated by Nakai low back pain operation curative effect grade, vertebral body height recovery rate and improvement of local kyphosis cobb angle.Results: the results showed that there was no significant difference among the three groups in the classification of Nakai low back pain after PVP / PKP / Vesselplasty. The Denis classification of osteoporotic compression fracture of thoracolumbar vertebrae was used to restore the height of vertebral body and improve the Cobb angle of thoracolumbar kyphosis in PVP group and Vesselplasty group.The effect of correction of local kyphosis of thoracolumbar vertebrae was statistically significant. There was significant difference between PKP group and Vesselplasty group in the recovery of vertebral body height and the improvement of Cobb angle of thoracolumbar local kyphosis.The correction of thoracolumbar kyphosis was significantly different from that of PVP group, but there was no significant difference between the two groups (p 0.05). The height of vertebral body was recovered in type A group after vertebroplasty in Denis classification of compression fracture, and there was no significant difference between the two groups in the correction of thoracolumbar kyphosis.The improvement of Cobb in thoracolumbar local kyphosis was not good compared with other groups. There was statistical difference in the recovery of vertebral body height and the improvement of Cobb in thoracolumbar local kyphosis.Conclusion 1.The clinical curative effect of PVP / PKP / Vesselplasty in the treatment of osteoporotic compression fracture of thoracolumbar vertebrae was significant. 2. PKP- Vesselplasty recovered the height of vertebra and improved the Cobb angle of thoracolumbar kyphosis.Correction of thoracolumbar kyphosis was better than that of PVP.In the Denis classification of OVCF compression fracture, Vertebroplasty was more effective in the recovery of vertebral height of type B and D than that of type A and C, followed by type A and type A. 4.In the Denis classification of OVCF compression fracture, type D was the best in improving the Cobb angle of thoracolumbar kyphosis.Denis classification of compression fracture has certain clinical significance in guiding the choice of different vertebroplasty in the treatment of thoracolumbar osteoporotic compression fracture in vertebral body height recovery, thoracolumbar local kyphosis Cobb angle improvement, correction of thoracolumbar local kyphosis deformity.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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