论文部分内容阅读
目的:探讨术前中医传统正骨手法复位、术中单侧椎弓根途径经皮椎体成形(PVP)、术后中药方剂脊椎方内服并配合以胸腰支具固定的一体化治疗模式对老年骨质疏松性椎体压缩性骨折的临床疗效。方法:回顾性分析84例老年骨质疏松性椎体压缩性骨折患者临床资料。所有患者给予全身麻醉下“V”型手术台上行牵引按压过伸手法复位,经单侧椎弓根入路行PVP术,术后内服中药脊椎方5d并配合胸腰支具外固定。患者出院后进行随访,观察其手术的一般情况,并分别通过对术前及术后3d、3个月、6个月进行VAS评分并计算改善率,测量椎体前、后缘高度及Cobb角,进行活动能力评分等指标评估疗效。结果:所有患者均手术顺利,术中未发生任何重要组织或器官损伤及其他手术意外。平均手术时间为(40±15)min,椎体骨水泥平均注入量(3.20±1.80)m L,平均出院时间为3d,均无骨水泥渗漏情况发生。术后VAS评分及活动能力评分与术前比较,差异均有统计学意义(P<0.05),术后椎体前、后缘高度及局部Cobb角与术前比较,差异均有统计学意义(P<0.05)。结论:中医传统正骨手法复位联合单侧椎弓根途径PVP、术后中药方剂脊椎方内服并配合以胸腰支具固定的一体化模式治疗老年骨质疏松性椎体压缩性骨折疗效满意,且安全、经济,值得临床推广。
Objective: To investigate the effect of preoperative traditional Chinese medicine on osteoporosis reduction, intraoperative unilateral pedicle percutaneous vertebroplasty (PVP), postoperative Chinese medicine prescription for spine and internal fixation with thoraco-lumbar support fixation Clinical efficacy of osteoporotic vertebral compression fractures. Methods: A retrospective analysis of 84 elderly patients with osteoporotic vertebral compression fractures clinical data. All patients under general anesthesia under the “V ” type operating table traction over the stretch method reduction, the unilateral pedicle approach PVP surgery, after oral administration of Chinese medicine spine 5d and external fixation with thoracolumbar. The patients were followed up after discharge to observe the general condition of the operation. VAS score was calculated before operation, 3d, 3months and 6months after operation respectively, and the improvement rate was calculated. The anterior and posterior vertebral height and Cobb angle , Activity score and other indicators of assessment of efficacy. Results: All the patients were operated smoothly without any important tissue or organ injury and other surgical accidents. The average operation time was (40 ± 15) min. The average volume of vertebral bone cement injection was (3.20 ± 1.80) m L and the average discharge time was 3d. No leakage of cement occurred. The postoperative VAS score and activity score were significantly different from those before operation (P <0.05). The anterior and posterior vertebral body height and local Cobb angle were significantly different from those before operation (P <0.05) P <0.05). CONCLUSION: The traditional Chinese medicine orthognathic surgery combined with unilateral pedicle approach PVP, postoperative Chinese medicine prescription spine oral administration and combined with thoracolumbar brace fixation integrated mode treatment of senile osteoporotic vertebral compression fractures with satisfactory results, and Safe, economical, worthy of clinical promotion.