论文部分内容阅读
目的:观察利用体位复位结合经皮椎体成形术(PVP)治疗老年骨质疏松性胸腰椎压缩性骨折(OVCF)的临床疗效。方法:选取初诊OVCF患者50例,术前采用体位复位后行PVP治疗。根据术前和术后侧位X线片测量椎体高度、后凸畸形角度(Cobb’s),进行视觉模拟疼痛(VAS)功能评分。结果:术前1天与术后3月的椎体前缘高度、Cobb’s角、VAS评分比较,差异均有统计学意义(P<0.05)。单节椎体手术时间30~60 min,平均40 min。每个椎体注入骨水泥量3~7 mL,平均3.5 mL。下地时间12~48 h,平均24 h。术中发生骨水泥渗漏6例(椎体前方漏2例,椎体侧方漏2例,椎体后方漏1例,椎间盘漏1例),未出现明显神经损害体征。41例在术后即感疼痛减轻或消失,6例出现一过性沉痛,1~3天后消失,3例患者术后仍有轻微疼痛,经过口服消炎止痛药及理疗等治疗后缓解。结论:体位复位法结合PVP治疗老年骨质疏松性胸腰椎压缩性骨折,在止痛和纠正脊柱后凸畸形方面具有肯定的效果,是一种比较微创、简单、安全的有效方法。
OBJECTIVE: To observe the clinical effect of percutaneous vertebroplasty (PVP) in the treatment of osteoporotic thoracolumbar vertebral compression fractures (OVCF). Methods: Fifty patients with newly diagnosed OVCF were selected. Preoperative PVP was performed after position reduction. Vertebral body height and Cobb’s were measured according to preoperative and postoperative radiographs, and visual analogue pain (VAS) score was evaluated. Results: There was significant difference in vertebral height, Cobb’s angle and VAS score between preoperative 1 day and 3 months postoperatively (P <0.05). Single vertebral body operation time 30 ~ 60 min, an average of 40 min. Each vertebral volume of bone cement into 3 ~ 7 mL, an average of 3.5 mL. Time to 12 ~ 48 h, an average of 24 h. There were 6 cases of intraoperative leakage of cement (2 cases of anterior leakage, 2 cases of lateral leakage, 1 case of posterior leakage, 1 case of intervertebral disc leakage). There was no obvious signs of nerve damage. 41 patients relieved or disappeared after operation. Six patients had transient painful pain and disappeared after 1-3 days. Three patients still had slight pain after operation and were relieved after oral administration of anti-inflammatory painkillers and physiotherapy. Conclusion: Postoperative reduction combined with PVP in the treatment of senile osteoporotic thoracolumbar vertebral compression fractures has a positive effect in relieving pain and correcting kyphosis, and is an effective, minimally invasive, simple and safe method.