过伸手法复位联合经皮椎体成形术治疗胸腰椎骨质疏松性压缩骨折的疗效观察

目的观察过伸手法复位联合经皮椎体成形术(PVP)治疗胸腰椎骨质疏松性压缩骨折的治疗效果。方法对于明确诊断胸腰椎骨质疏松性压缩骨折的33例患者(42个椎体),采用术中过伸手法复位骨折联合PVP治疗。分别在术前、术后3天、术后3个月、术后12个月对患者进行疼痛视觉模拟评分(visual analogue scale,VAS)、伤椎前中部高度丢失百分比及后凸畸形Cobb角等指标来评估治疗效果。结果术后VAS评分都有明显下降,与术前相比有显著性差异(P<0.05),后凸畸形及椎体高度与术前比较差异有统计学意义(P<0.05),发生骨水泥向椎体前方渗漏2例,侧方渗漏2例,向椎间盘内渗漏1例,无椎体后方渗漏。结论过伸手法复位联合经皮椎体成形术能有效矫正胸腰椎椎体压缩性骨折引起的后突畸形,减轻疼痛症状,是治疗胸腰椎骨质疏松性压缩骨折的有效方法。

Over-extending reduction combined with percutaneous vertebroplasty for the treatment of thoraco- lumbar vertebral compression fractures due to osteoporosis

Objective To assess the clinical effect of over-extending reduction combined with per- cutaneous vertebroplasty （PVP）in treating thoracolumbar vertebral compression fractures caused by osteoporosis. Methods A total of 33 patients（44 vertebras） with vertebral compression fractures due to osleoporosis were treated with over-extending reduction by using traction on the operation table, and then PVP was performed on the fractured vertebra. The visual analogue scale（VAS） was used to evaluate the clinical effectiveness. The preoperative and postoperative heights of the fractured vertebral body and Cobb angle were determined. Results After the treatment VAS score significantly decreased （P 〈 0.05） and the vertebral height were significantly improved（P 〈 0. 05）. Bone cement leakage was observed in front of the vertebral body（ n = 2） , in the side of vertebral body（ n = 2） and within the intervertebral disc （n = 1 ）. Conclusion The over-extending reduction combined with PVP is an effective treatment for thoracolumbar vertebral compression fractures caused by osteoporosis.