矫形复位结合椎体成形术治疗椎体压缩性骨折的临床应用

目的:探讨矫形复位结合经皮穿刺椎体成形术治疗脊椎疾病合并椎体压缩性骨折的方法及临床价值。方法:对234例268个椎体的胸、腰椎压缩性骨折患者行术前及术中手法矫形复位,使压缩椎体形态改善后行经皮穿刺椎体成形术。观察手术前后椎体形态的变化和疼痛缓解情况,进行对照分析。结果:椎体内骨水泥注射量3.5～9.0mL,椎体骨髓腔内骨水泥分布平均大于椎体体积一半者占90.7%,接近99%的压缩椎体前缘高度有一定程度增高或恢复,压缩的椎体前缘增高幅度1～6mm,平均2.5mm;术后一周的治疗有效率100%,优良率92.5%。结论:矫形复位结合椎体成形可以达到恢复椎体形态和增加椎体强度的双重效果,显著提高椎体成形术镇痛和稳定脊柱的有效率,症状缓解与成形术前后椎体形态的改善具有一定的依存关系。

Clinical Application of Restitution Combined Vertebral Hasty in Treatment of Vertebral Compression Fracture

Objective To explore the method and clinical value of restitution combined with pereutaneous vertebreplasty （PYP） in treatment of compression fracture of thoracic or lumbar vertebral body. Methods Two hundreds and thirty-four eases involved in 268 vertebral bodies of compression fracture were performed manipulation before and during operation, and pereutaneous vertebroplasty were given after the compressed vertebral shape improved. The changes of vertebral morphology and the scenario of pain relief before and after operation were observed and analyzed. Results The volume of injected PMMA was 3.5 - 9.0 mL, the mean disposition of bone cement in bone marrow of vertebral body that exceeded half of vertebral body was 90.7%, about 99% anterior vertebral height of compressed vertebral bodies were increased or recovered, the context of increased anterior vertebral height was 1 - 6 mm,the mean value was 2.5 mm;the efficacy rate was 100% one week postoperation,the exeeUent rate was 92.5%. Coflclusiorl Restitution combined pereutaneous vertebroplasty could achieve double effects of vertebral morphological recovery and strength enhaneement,signiiieantly improve the effective rate of PYP analgesic effect and stabilizing the spine, symptom remission may be related to the vertebral morphological improvement before and after operation.