手法复位联合PVP与单纯PVP治疗骨质疏松性胸腰段脊柱压缩骨折的效果比较

目的 比较手法复位联合经皮椎体成形术(PVP)与单纯PVP治疗骨质疏松性胸腰段脊柱压缩骨折的效果.方法 选取2018年1月至2020年7月我院收治的200例骨质疏松性胸腰段脊柱压缩骨折患者作为研究对象,将其随机分为A组和B组,各100例.A组行手法复位联合PVP,B组行PVP.比较两组的治疗效果.结果 术后3 d及3个月,A组的VAS、ODI评分低于B组,伤椎前缘高度高于B组,椎体后凸Cobb角小于B组(P<0.05).术后3个月,A组的血清瘦素、PⅠNP水平低于B组,BMD高于B组(P<0.05).术后3个月,A组的IL-6、MMP-3水平低于B组,TIMP-1水平高于B组(P<0.05).A组Ⅰ、Ⅱ度患者占比高于B组,Ⅲ、Ⅳ度患者占比低于B组(P<0.05).结论 与单纯PVP相比,手法复位联合PVP治疗骨质疏松性胸腰段脊柱压缩骨折患者的效果显著.

Comparison of effects manual reduction combined with PVP and PVP alone in the treatment of osteoporotic thoracolumbar compression fractures

Objective To compare the effects of manual reduction combined with percutaneous vertebroplasty(PVP)and PVP alone in the treatment of osteoporotic thoracolumbar compression fractures.Methods A total of 200 patients with osteoporotic thoracolumbar compression fractures treated in our hospital from January 2018 to July 2020 were selected as the research objects.The patients were randomly divided into group A and group B,with 100 cases in each group.The group A received manual reduction combined with PVP,and the group B received PVP.The therapeutic effects of the two groups were compared.Results At 3 d and 3 months after operation,the VAS and ODI scores of the group A were lower than those of the group B,the height of anterior edge of injured vertebra was higher than that of the group B,and the Cobb angle of kyphosis was lower than that of the group B(P<0.05).At 3 months after operation,the levels of serum leptin and PⅠNP in the group A were lower than those in the group B,and BMD was higher than that in the group B(P<0.05).At 3 months after operation,the IL-6 and MMP-3 levels in the group A were lower than those in the group B,and the TIMP-1 level was higher than that in the group B(P<0.05).The proportion of patients with gradeⅠandⅡin the group A was higher than that in the group B,and the proportion of patients with gradeⅢandⅣwas lower than that in the group B(P<0.05).Conclusion Compared with PVP alone,manual reduction combined with PVP in the treatment of osteoporotic thoracolumbar compression fractures has significant effect.