改良闭合复位联合经皮椎体成形术治疗骨质疏松性脊柱压缩骨折的疗效观察

目的探索改良闭合复位联合经皮椎体成形术（PVP）治疗骨质疏松性脊柱压缩骨折的临床效果。方法患者俯卧于手术床，腹部悬空，升高手术床头、尾，于C型臂透视下先行手法闭合复位，再进行PVP治疗。在术前、术后3d、术后6个月随访时进行疼痛视觉类比评分（VAS）、计算椎体前后缘高度比值（Beck值）和脊柱后凸畸形Cobb角。结果38例44个椎体操作成功，骨水泥向椎体前方、侧方渗漏各1例，无椎体后方（椎管内）渗漏。VAS评分由术前8．5±1．2降低至2．5±1．4，Beck值由术前31．7±5．6升高至72．6±4．6，Cobb角由术前25．4°±7．3°改善至13．4°±5．2°。结论手术床俯卧位闭合复位联合PVP是治疗骨质疏松性脊柱压缩骨折的有效方法。

Effect of closed reduction in combinantion with percutaneous vertebroplasty for the treatment of osteoporosis vertebral compression fractures

Objective To explore the effect of closed reduction in combination with percutaneous vertebroplasty （PVP） for the treatment of osteoporosis vertebral compression fractures. Methods Thirty-eight patients with osteoporosis vertebral compression fractures were treated with closed reduction under c-arm x-ray monitoring by extending on the operating table, and then PVP was performed on the fractured vertebra. The results of pre-operation, 3 days after and 6 monthes after the operation were quantitatively evaluated according to the concept of estimated vertebral height loss and Cobb angle of the vertebral compression fracture. Results Operations on the 44 vertebraes of 38 cases were successful. Bone cement leakage happened in two cases including anterial and lateral leakge without posterial leakage. Pain scores ,vertebral heights and Cobb angle improved significantly （P 〈 0.05 ） after the surgery. Condusion The modified closed reduction in combination with PVP was effective in the treatment of osteoporosis vertebral compression fractures.