【摘要】 目的:比较经皮椎体后凸成形术(percutaneous kypho plasty,PKP)配合正骨手法治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)伴椎体内裂隙样变(intravertebral vacuumcleft,IVC)的疗效。方法:选择OVCF伴IVC患者86例,按照随机数字表法分为治疗组和对照组,对照组给予PKP治疗,治疗组在对照组基础上给予正骨手法治疗。分别于术前、术后1周、术后1个月、术后6个月采用疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评价疼痛缓解及功能改善程度;采用影像学对伤椎高度、后凸Cobb角进行对比。结果:两组治疗前后椎前缘高度、Cobb角、VAS评分、ODI评分组间、治疗前后、交互作用经重复测量分析差异均有统计学意义(P<0.001);两组渗漏率差异无统计学意义(χ~2=1.325,P=0.433>0.05)。结论:PKP配合正骨手法治疗OVCF伴IVC,能够恢复椎体的顺应性、维持脊柱稳定性、提高患者生存质量,且安全性高。更多还原

【Abstract】 Objectives To compare the efficacy of percutaneous kyphoplasty(PKP) combined with bonesetting manipulation in treatment of osteoporotic vertebral compression fractures(OVCF) and intravertebral vacuumcleft(IVC), and explore the mechanism. Methods The patients(86 cases) with OVCF and IVC who visited the orthopedics department were selected and divided into experimental group and control group according to the random number table, each group had 43 cases. The patients in control group were treated with PKP, and the patients in experimental group were given bone-setting manipulation on the basis of the control group. Visual-analogue scale(VAS) score and Oswestry disability index(ODI) were used to evaluate the pain relief and functional improvement before surgery, 1 week after surgery, 1 month after surgery and 6 months after surgery; the height of injured vertebral and angle of Cobb were compared by imaging. Results Frontal height, Cobb angle, VAS score and ODI score before and after treatment between two groups were statistically significant different. The interaction was analyzed by repeated measurements and the difference was statistically significant(P<0.001). There was no statistically significant difference in total leakage rate between the two groups in postoperative(χ~2=1.325,P=0.433>0.05). Conclusion PKP combined with bone-setting manipulation can restore the compliance of vertebral body, maintain the stability of spine, improve the quality of life of patients, and has high safety, which is worthy of clinical promotion.更多还原