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目的探讨单侧经皮椎体成形术(PVP)结合小关节囊封闭术治疗高龄骨质疏松性胸腰椎骨折的疗效。方法自2013-04—2015-06采用单侧经椎弓根入路PVP结合小关节囊封闭术治疗骨质疏松症伴胸腰椎新鲜骨折19例(观察组),同期仅接受单侧经椎弓根入路PVP手术治疗的23例纳入对照组。结果 42例均获得随访4~18个月,平均8个月。2组骨水泥注入量、骨折椎体压缩改善程度、后凸Cobb角矫正度数差异无统计学意义(P>0.05);但观察组手术时间较对照组长,差异有统计学意义(P<0.05)。观察组术后24 h、3个月VAS评分、ODI指数均明显低于对照组,差异有统计学意义(P<0.05);但6个月时2组VAS评分、ODI指数差异无统计学意义(P>0.05)。结论单侧PVP结合小关节囊封闭术治疗高龄骨质疏松性胸腰椎骨折创伤小、术后短期止痛效果更好,可更快恢复患者行走能力。
Objective To investigate the curative effect of unilateral percutaneous vertebroplasty (PVP) combined with facet joint capsule in the treatment of elderly osteoporotic thoracolumbar fractures. Methods From April 2013 to June 2015, 19 patients with osteoporosis complicated by thoracolumbar fractures were treated with unilateral trans-pedicular approach with PVP combined with facet joint capsule closure (observation group) 23 patients underwent PVP surgery were included in the control group. Results 42 cases were followed up for 4 to 18 months with an average of 8 months. There was no significant difference in the degree of correction of the Cobb angle between the two groups (P> 0.05). However, the operation time of the observation group was longer than that of the control group (P <0.05) ). The VAS score and ODI index in observation group at 24 h and 3 months after operation were significantly lower than those in control group (P <0.05). However, there was no significant difference in VAS score and ODI index between the two groups at 6 months (P> 0.05). Conclusion Unilateral PVP combined with facet joint capsule in the treatment of elderly patients with osteoporotic thoracolumbar fractures is less traumatic and the postoperative short-term analgesic effect is better and the walking ability can be recovered more quickly.