编织囊袋扩张-椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折疗效观察

目的:探讨编织囊袋扩张-椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折临床疗效。方法:回顾性分析60例骨质疏松性胸腰椎压缩性骨折病人的临床资料。根据手术方式不同，将其分为观察组（手术采用编织囊袋扩张-椎体后凸成形术）和对照组（手术采用传统椎体后凸成形术），各30例。所有病人均获随访4~12个月。比较2组手术情况、手术前后ODI及VAS评分、伤椎Cobb角及前缘高度以及骨水泥渗漏等并发症发生情况。结果:2组病人在出血量及手术时间方面差异均无统计学意义（P>0.05）。各时间点，2组病人间VAS、ODI差异均无统计学意义（P>O.05）；2组病人术后24 h及末次随访时的VAS、ODI评分均显著低于术前（P<0.01）。2组病人在同一时间点的伤椎Cobb角及椎体前缘高度之间的差异均无统计学意义（P>0.05）。观察组的Cobb角平均矫正值为（6.8±3.5）°，对照组为（7.9±3.1）°，差异无统计学意义（P>0.05）。2组病人在术后24 h及末次随访与术前相比，伤椎Cobb角及椎体前缘高度差异均有统计学意义（P<0.01）。观察组未出现骨水泥渗漏，对照组的骨水泥渗漏率为22.6%（7/31），差异有统计学意义（P<0.05）。结论:编织囊袋扩张-椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折安全有效，避免了骨水泥渗漏，可应用于椎体后壁不完整的骨质疏松性胸腰椎压缩性骨折。

Effect of vesselplasty in the treatment of osteoportic vertebral compression fractures

Objective:To evaluate the clinical efficacy of vesselplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures.Methods:The clinical data of 60 patients with osteoporotic vertebral compression were retrospectively analyzed.According to the surgical procedures,the patients were divided into the observation group(treated with vesselplasty) and control group(treated with traditional kyphoplasty)(30 cases each group).Two groups were followed up for 4-12 months.The operation condition,scores of VAS and ODI,anterior vertebral body height,Cobb angle and bone cement leakage between two groups were compared.Results:The differences of the intraoperative bleeding and operation time between two groups were not statistically significant(P>0.05).The differences of the scores of VAS and ODI at all time-point between two groups were not statistically significant(P>0.05),and the scores of VAS and ODI in two groups after 24 h of operation and at the end of following up were significantly lower than those before operation(P<0.01).The differences of the anterior vertebral body height and Cobb angle between two groups at the same time-point were not statistically significant(P>0.05).The average correction value of Cobb angle in observation group and control group were (6.8±3.5)° and (7.9±3.1)°,respectively,and the difference of which was not statistically significant(P>0.05).The differences of the anterior vertebral body height and Cobb angle in two groups between before operation,and after 24 h of operation and at the end of following up were statistically significant(P<0.01).The bone cement leakage was not found in observation group,the bone cement leakage rate in control group was 22.6%(7/31),and the difference of which between two groups was statistically significant(P<0.05).Conclusions:The treatment of thoracolumbar osteoporotic vertebral compression fractures with vesselplasty is safe and effective,which can avoid the cement leakage,especially in the fractures with posterior wall damage.