本文關(guān)鍵詞： 骨質(zhì)疏松 脊柱骨折 椎體成形術(shù) 組織工程 骨科植入物 脊柱植入物 椎體骨折 膨脹式椎弓根螺釘 經(jīng)皮椎體成形術(shù) 經(jīng)皮椎體后凸成形術(shù)　出處：《中國組織工程研究》2017年03期 　論文類型：期刊論文

【摘要】：背景:經(jīng)皮椎體成形、經(jīng)皮椎體后凸成形和膨脹式椎弓根螺釘內(nèi)固定均可修復(fù)原發(fā)性骨質(zhì)疏松性胸腰椎骨折,這3種方法各有其優(yōu)缺點。目的:探討原發(fā)性骨質(zhì)疏松性胸腰椎骨折的修復(fù)方式及效果。方法:納入61例診斷為原發(fā)性骨質(zhì)疏松性胸腰椎骨折的患者,入院后積極做好圍手術(shù)期的治療和處理,分別采取經(jīng)皮椎體成形、經(jīng)皮椎體后凸成形和膨脹式椎弓根螺釘置入內(nèi)固定治療,記錄所有患者術(shù)前、術(shù)后3個月的疼痛目測類比評分和Oswestry功能障礙指數(shù)(ODI),以及術(shù)前、術(shù)后3 d及術(shù)后3個月傷椎的矢狀面指數(shù)和Cobb角等指標(biāo)并進(jìn)行統(tǒng)計分析。結(jié)果與結(jié)論:(1)所有患者術(shù)后均獲得隨訪,隨訪時間12-18個月;(2)3組患者術(shù)前的疼痛目測類比評分、ODI、傷椎的矢狀面指數(shù)及Cobb角比較差異無顯著性意義(P0.05);(3)3組術(shù)后3個月的疼痛目測類比評分、ODI均較術(shù)前降低,差異有顯著性意義(P0 05),組間比較疼痛目測類比評分、ODI差異無顯著性意義(P0.05);(4)3組術(shù)后3 d、術(shù)后3個月傷椎的矢狀面指數(shù)、Cobb角均較術(shù)前增大,差異有顯著性意義(P0 05),組間比較差異有顯著性意義(P0 05),經(jīng)皮椎體后凸成形組與膨脹式椎弓根螺釘內(nèi)固定組效果類似(P0.05),且優(yōu)于經(jīng)皮椎體成形組(P0.05);(5)結(jié)果說明,3種修復(fù)方式均能有效恢復(fù)椎體高度和強(qiáng)度,緩解疼痛,穩(wěn)定脊柱,術(shù)后短期內(nèi)椎體無明顯的壓縮;但在術(shù)后椎體高度的恢復(fù)程度方面,經(jīng)皮椎體后凸成形、膨脹式椎弓根螺釘內(nèi)固定優(yōu)于經(jīng)皮椎體成形。另外,3種修復(fù)方案均有各自的適應(yīng)證、優(yōu)缺點,正確選擇修復(fù)方式是提高修復(fù)效果的關(guān)鍵。
[Abstract]:Background: percutaneous vertebroplasty, percutaneous kyphoplasty and internal fixation with expanded pedicle screw can be used to repair primary osteoporotic thoracolumbar fractures. Objective: to investigate the repair methods and effects of primary osteoporotic thoracolumbar fractures. Methods: 61 patients with primary osteoporotic thoracolumbar fractures were included. The patients were treated with percutaneous vertebroplasty, percutaneous vertebral kyphoplasty and internal fixation with expansion pedicle screw. All the patients were recorded before operation. The pain visual analogies score and Oswestry dysfunction index were evaluated 3 months after operation and before operation. Sagittal index and Cobb angle of injured vertebrae were analyzed 3 days after operation and 3 months after operation. Results and conclusion all patients were followed up after operation. The postoperative pain visual analogue score (ODI), sagittal index (SMI) and Cobb angle of the injured vertebrae were not significantly different in the follow-up period of 12 to 18 months after operation in the 3 groups (P 0.05) and the visual analogue scores of pain in the 3 groups were lower than those before operation. The difference was significant (P 0.05). There was no significant difference in visual analogue scores of pain and ODI between the groups. The sagittal index and Cobb angle of the injured vertebrae were increased 3 days after operation in the 3 groups, and the Cobb angle of the injured vertebrae was increased 3 months after operation. There was a significant difference between the two groups (P 0.05). The effect of percutaneous kyphoplasty group and expansion pedicle screw fixation group was similar to that of the expansion pedicle screw fixation group, and better than that of the percutaneous vertebroplasty group. All the methods can effectively restore the height and strength of the vertebrae. Relief of pain, stabilization of the spine, no obvious compression of the vertebral body in a short period of time after the operation, but in terms of the degree of recovery of the height of the vertebral body after the operation, the percutaneous vertebrae kyphosis, Expansion pedicle screw internal fixation is superior to percutaneous vertebroplasty. In addition, all three repair schemes have their own indications, advantages and disadvantages, the correct selection of repair methods is the key to improve the repair effect.
【作者單位】： 重慶市中醫(yī)院骨二科;成都體育學(xué)院附屬醫(yī)院;
【分類號】：R687.3;R580

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