【摘要】 目的 探讨微创椎弓根螺钉内固定(PSF)联合经皮椎体成形术(PVP)预防胸腰椎骨质疏松性椎体压缩性骨折(OVCF)再骨折的临床疗效。方法 选取2011年7月至2013年5月收治的胸腰椎OVCF且无合并神经症状的患者56例,随机分为对照组(n=29例)和观察组(n=27例)。对照组只行双侧PVP,观察组行PSF联合PVP,比较两组手术时间、骨水泥注入量、骨水泥分布和外漏情况,术前术后疼痛视觉模拟评分(VAS),测量患者术后X线片矢状面Cobb角和椎体高度恢复情况。结果 对照组骨水泥注入量(5.1±1.2)ml,手术时间(31.2±3.8)min;观察组骨水泥注入量(5.4±1.4)ml,手术时间(65.7±5.3)min。所有病例随访2年,观察组术后14d、30d、2个月、6个月、1年、2年VAS评分显著低于对照组(P<0.05);观察组术后Cobb’s角显著低于对照组(P<0.05);观察组术后各时点椎体高度恢复率显著高于对照组(P<0.05)。结论 微创PSF联合PVP可以有效预防OVCF再骨折的发生。更多还原

【Abstract】 Objective To evaluate the preventive effect ofminimally invasive pedicle screw fixation combined with percutaneous vertebral angioplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures.Methods 56 patients in our hospital from July 2011 to May 2013 in our hospital were selected,who sustained thoracolumbar osteoporotic vertebral compression fractures and no complicated with nervous symptoms of patients were randomly divided into 2 groups:29 cases of PVP group(control group),27 cases ofminimally invasive pedicle screw internal fixation combined with PVP group(experimental group),the control group only underwent bilateral percutaneous vertebroplasty operation,experimental group underwent pedicle screw fixation combined with percutaneous vertebroplasty surgery,compared with two groups of surgical operation time,bone cement injection volume,bone cement distribution and leakage,preoperative and postoperative pain visual analogue scale(VAS) measurement in patients with postoperative X-ray sagittal plane Cobb angle and vertebral height restoration.Results In control group,bone cement injection volume was(5.1 + 1.2) ml,operation time was(31.2+3.8) min,bone cement injection volume of the experimental group was(5.4+ 1.4) ml,operation time was(65.7 + 5.3) min.All patients were followed up for 2 years,after operation in the experimental group was 14 days,30 days,2 months,6 months,1 year,2 years VAS score was significantly lower man that of control group(P<0.05);experimental group after Cobb’s angle was significantly lower than that of control group(P<0.05);after surgery in the experimental group at each time point in the vertebral height restoration was significantly higher than that in control group(P<0.05).Conclusion Minimally invasive pedicle screw fixation combined with percutaneous vertebral angioplasty can effectively prevent the occurrence of OVCF re fracture.更多还原