| 单球囊双侧交替扩张后凸成形术治疗骨质疏松性椎体压缩骨折的病例对照研究 |
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Received:February 26, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 何磊 |
HE Lei |
绍兴市人民医院骨科, 浙江 绍兴 312000 |
Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing 312000, Zhejiang, China |
doctor312000@gmail.com |
| 钱宇 |
QIAN Yu |
绍兴市人民医院骨科, 浙江 绍兴 312000 |
Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing 312000, Zhejiang, China |
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| 金以军 |
JIN Yi-jun |
绍兴市人民医院骨科, 浙江 绍兴 312000 |
Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing 312000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2014年27卷，第12期，第1056-1061页 |
| DOI：10.3969/j.issn.1003-0034.2014.12.020 |
| 基金项目:国家自然科学基金(编号:81271974) |
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目的: 比较椎体后凸成形术治疗骨质疏松性椎体一般压缩骨折与严重压缩骨折的临床疗效.
方法: 自2009年1月至2011年2月,对60例(70椎)骨质疏松性椎体压缩骨折患者采用单球囊双侧交替扩张后凸成形术结合体位复位治疗,其中男10例,女50例;年龄59～90岁,平均72.1岁.其中一般压缩骨折患者38例(44个椎体),男7例,女31例;年龄59～87岁,平均(71.8±6.1)岁,二椎体骨折6例,T9 1椎,T10 5椎,T11 7椎,T12 13椎,L19椎,L24椎,L34椎,L4 1椎.严重压缩骨折患者22例(26个椎体),男3例,女19例;年龄63～90岁,平均(72.6±7.2)岁;二椎体骨折4例,T9 1椎,T10 2椎,T11 3椎,T12 9椎,L16椎,L23椎,L32椎.比较两组患者的手术时间、骨水泥注射量及手术前后椎体高度和Cobb角的改变,计算两组术后椎体高度平均恢复率与Cobb角的平均矫正度,采用视觉模拟评分VAS进行疗效评价.
结果: 所有患者均安全完成手术,术后72 h内疼痛均明显缓解,两组患者均获得随访,时间6～13个月,平均10.1个月.两组术后椎体高度、Cobb角、VAS评分均较术前改善(P<0.05).椎体一般骨折组手术时间短于严重椎体骨折组(P<0.05),而骨水泥注入量大于椎体严重骨折组(P<0.05),且椎体一般骨折组在术后椎体平均恢复率与Cobb角的平均矫正度均优于椎体严重骨折组(P<0.05),而两组患者手术前后VAS评分比较差异无统计学意义(P>0.05).椎体一般骨折组有3例(3椎)发生骨水泥渗漏(6.8%),椎体严重骨折组有5例(5椎)发生骨水泥渗漏(19.2%),两组比较差异无统计学意义(P>0.05).
结论: 椎体后凸成形术治疗骨质疏松性椎体一般压缩骨折及椎体严重压缩骨折均可获得满意疗效,椎体一般压缩骨折患者在椎体高度恢复及Cobb较矫正上优于椎体严重压缩骨折患者. |
| [关键词]:骨质疏松 骨折,压缩性 病例对照研究 |
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| Bilateral transpedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compressive fractures |
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Abstract:
Objective: To compare clinical outcomes of bilateral transpedicular balloon kyphoplasty for the treatment of ordinary osteoporotic vertebral compressive fracture(OVCF) and severe osteoporotic vertebral compressive fracture.
Methods: From Junary 2009 to Febuary 2011,60 patients(70 vertebrae) with osteoporotic vertebral compressive fracture were included. All patients were treated by bilateral transpedicular balloon kyphoplasty combined with postural reduction,including 10 males and 50 females aged from 59 to 90 years old with an average of 72.1 years old. In ordinary osteoporotic vertebral compressive fracture group,there were 38 patients(44 vertebrae) including 7 males and 31 females aged from 59 to 87 years old with an average of (71.8±6.1) years old. There were 6 patients with two vertebral fractures,1 vertebra in T9,5 vertebrae in T10,7 vertebrae in T11,13 vertebrae in T12,9 vertebrae in L1,4 vertebrae in L2,4 vertebrae in L3,1 vertebra in L4. While in severe osteoporotic vertebral compressive fracture group,there were 22 patients (26 vertebrae) including 3 males and 19 females aged from 63 to 90 years old with an average of (72.6±7.2) years old. There were 4 patients with two vertebral fractures,1 vertebra in T9,2 vertebrae in T10,3 vertebrae in T11,9 vertebrae in T12,6 vertebrae in L1,3 vertebrae in L2,2 vertebrae in L3. Operative time,volume of bone cement injection,and vertebral height and changes of Cobb angle before and after operation were observed and compared. Postoperative average recovery rate of vertebral height and correct degree of Cobb angle were caculated and compared,VAS scoring were used to evaluate therapeutic effect.
Results: All operations were completed sucessfully,and pain were relieved at 72 h after operation. All patients were followed up from 6 to 13 months with an average of 10.1 months. Postoperative vertebral height,Cobb angle and VAS score were improved better than that of before operation (P<0.05). Operative time in ordinary group was shorter than severe group,while volume of bone cement injection was more than that of severe group. Average recovery rate of vertebral height and correct degree of Cobb angle in ordinarty group was better than that of in severe group(P<0.05). There was no significant differences between two groups in VAS scores before and after operation(P>0.05). Three cases(3 vertebrae) ocurred bone cement leakage in ordinarty group,while 5 cases (5 vertebrae) ocurred bone cement leakage in severe group,and there was no meaning between two groups(P>0.05).
Conclusion: Kyphoplasty could receive satisfied curative effect in treating ordinary and servere patients with osteoporotic vertebral compressive fracture,but recovery of vertebral height and correct degree of Cobb angle in ordinary gourp was better than that of in servere group. |
| KEYWORDS:Osteoporosis Fractures,compression Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 何磊,钱宇,金以军.单球囊双侧交替扩张后凸成形术治疗骨质疏松性椎体压缩骨折的病例对照研究[J].中国骨伤,2014,27(12):1056~1061 |
| 英文格式: | HE Lei,QIAN Yu,JIN Yi-jun.Bilateral transpedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compressive fractures[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(12):1056~1061 |
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