本文選題：壓縮骨折Denis分型 + 椎體高度��； 參考：《山東中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探究壓縮骨折Denis分型對(duì)不同椎體成形術(shù)恢復(fù)椎體高度、改善局部后凸cobb角療效的影響。方法:回顧性分析2015年4月~2016年1月間于我院脊柱骨科經(jīng)三種不同椎體成型手術(shù)治療與隨訪的骨質(zhì)疏松性壓縮骨折的病例174例,從中篩選出124例病例并分組,對(duì)此病例資料進(jìn)行Nakai腰痛手術(shù)療效分級(jí)、椎體高度恢復(fù)率及改善局部后凸cobb角的療效評(píng)價(jià)。結(jié)果:分析比較PVP、PKP、Vesselplasty術(shù)后Nakai腰痛療效分級(jí),三者無(wú)統(tǒng)計(jì)學(xué)差異(p0.05);胸腰椎骨質(zhì)疏松性壓縮骨折的Denis分型對(duì)PVP組、PKP組和Vesselplasty組在恢復(fù)椎體高度,改善胸腰椎局部后凸Cobb角,糾正胸腰椎局部后凸畸形的療效影響,其差異存在統(tǒng)計(jì)學(xué)意義(p0.05)。PKP組與Vesselplasty組在對(duì)患者椎體高度恢復(fù)、改善胸腰椎局部后凸Cobb角,糾正胸腰椎局部后凸畸形上與PVP組對(duì)比有顯著差異,而兩組間對(duì)比無(wú)明顯差異(p0.05);壓縮骨折Denis分型中A型組經(jīng)椎體成形術(shù)治療后恢復(fù)椎體高度,改善胸腰椎局部后凸Cobb與其他組比較效果差,有統(tǒng)計(jì)學(xué)差異(P0.05),B型組、D型組在恢復(fù)椎體高度,胸腰椎局部后凸Cobb改善中效果較好。結(jié)論:1.椎體成形術(shù)PVP、PKP、Vesselplasty在治療胸腰椎體骨質(zhì)疏松性壓縮骨折緩解胸腰背部疼痛臨床療效顯著。2.PKP、Vesselplasty在對(duì)椎體高度恢復(fù)、胸腰椎局部后凸Cobb角改善,糾正胸腰椎局部后凸畸形方面較PVP手術(shù)效果好。3.椎體成形術(shù)在治療OVCF壓縮骨折Denis分型中B型、D型在椎體高度恢復(fù)方面比A型、C型效果好,C型次之,A型最差。4.椎體成形術(shù)在治療OVCF壓縮骨折Denis分型中D型在改善胸腰椎局部后凸Cobb角方面最好,B型稍次之,C型次之,A型最差。5.壓縮骨折Denis分型對(duì)指導(dǎo)選擇不同椎體成形術(shù)治療胸腰椎骨質(zhì)疏松性壓縮骨折在椎體高度恢復(fù)、胸腰椎局部后凸Cobb角改善,糾正胸腰椎局部后凸畸形方面具有一定臨床意義。
[Abstract]:Objective: to investigate the effect of Denis classification of compression fracture on restoring vertebral height and improving cobb angle of local kyphosis.Methods: from April 2015 to January 2016, 174 cases of osteoporotic compression fractures were treated and followed up by three different vertebrae orthopaedics in our hospital. 124 cases were selected and divided into two groups.The clinical data of this case were evaluated by Nakai low back pain operation curative effect grade, vertebral body height recovery rate and improvement of local kyphosis cobb angle.Results: the results showed that there was no significant difference among the three groups in the classification of Nakai low back pain after PVP / PKP / Vesselplasty. The Denis classification of osteoporotic compression fracture of thoracolumbar vertebrae was used to restore the height of vertebral body and improve the Cobb angle of thoracolumbar kyphosis in PVP group and Vesselplasty group.The effect of correction of local kyphosis of thoracolumbar vertebrae was statistically significant. There was significant difference between PKP group and Vesselplasty group in the recovery of vertebral body height and the improvement of Cobb angle of thoracolumbar local kyphosis.The correction of thoracolumbar kyphosis was significantly different from that of PVP group, but there was no significant difference between the two groups (p 0.05). The height of vertebral body was recovered in type A group after vertebroplasty in Denis classification of compression fracture, and there was no significant difference between the two groups in the correction of thoracolumbar kyphosis.The improvement of Cobb in thoracolumbar local kyphosis was not good compared with other groups. There was statistical difference in the recovery of vertebral body height and the improvement of Cobb in thoracolumbar local kyphosis.Conclusion 1.The clinical curative effect of PVP / PKP / Vesselplasty in the treatment of osteoporotic compression fracture of thoracolumbar vertebrae was significant. 2. PKP- Vesselplasty recovered the height of vertebra and improved the Cobb angle of thoracolumbar kyphosis.Correction of thoracolumbar kyphosis was better than that of PVP.In the Denis classification of OVCF compression fracture, Vertebroplasty was more effective in the recovery of vertebral height of type B and D than that of type A and C, followed by type A and type A. 4.In the Denis classification of OVCF compression fracture, type D was the best in improving the Cobb angle of thoracolumbar kyphosis.Denis classification of compression fracture has certain clinical significance in guiding the choice of different vertebroplasty in the treatment of thoracolumbar osteoporotic compression fracture in vertebral body height recovery, thoracolumbar local kyphosis Cobb angle improvement, correction of thoracolumbar local kyphosis deformity.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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