单侧经皮椎体后凸成形术联合针刀治疗单节段骨质疏松性胸腰椎压缩性骨折的临床观察

周文静; 李华杰; 孙欢; 闵有宝; 刘磊; 周平辉

doi:10.16766/j.cnki.issn.1674-4152.0033233

单侧经皮椎体后凸成形术联合针刀治疗单节段骨质疏松性胸腰椎压缩性骨折的临床观察

doi: 10.16766/j.cnki.issn.1674-4152.0033233

1.
安徽中医药大学附属滁州市中西医结合医院骨伤二科，安徽滁州 239000
2.
蚌埠医学院第一附属医院骨科，安徽蚌埠 233004

基金项目:

国家自然科学基金项目 31700854

详细信息

通讯作者:
周文静，E-mail：66417686@qq.com

中图分类号: R683.2 R687.42
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- 被引次数: 0
出版历程
- 收稿日期: 2023-04-18
- 网络出版日期: 2024-01-13

Efficacy of percutaneous unilateral balloon kyphoplasty combined with small-needle knife in the treatment of postoperative pain from single-level osteoporotic thoracolumbar vertebral compression fractures

1.
Department 2 of Orthopedics, Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine, Anhui University of Traditional Chinese Medicine, Chuzhou, Anhui 239000, China

摘要

摘要: 目的探讨单节段骨质疏松性胸腰椎压缩性骨折采用单侧经皮穿刺球囊扩张椎体后凸成形术联合小针刀治疗的临床疗效。方法选择滁州市中西医结合医院2017年7月—2019年3月骨伤二科收治的符合纳入与排除标准的单节段骨质疏松性胸腰椎压缩性骨折患者共46例，统计患者年龄、性别、病变椎体节段等一般资料，统计术前、术后24 h、针刀治疗后、术后6个月VAS评分，术前、术后、术后6个月Cobb角以及6个月内神经症状及再发压缩骨折情况。结果 46例患者术后疼痛较术前均明显改善，手术前后VAS评分、Cobb角比较差异有统计学意义[(2.63±0.74)分vs. (7.30±0.66)分、(8.78±0.16)° vs. (15.52±0.27)°，均P＜0.05]。其中1例患者发生骨水泥渗漏，无心肺系统及下肢血栓并发症发生，无死亡患者。结论单侧经皮穿刺球囊扩张椎体后凸成形术联合小针刀治疗单节段骨质疏松性压缩性骨折能够快速缓解患者疼痛，可有效提高老年患者的生活质量，安全性较好。
- 骨质疏松性椎体压缩性骨折 /
- 椎体后凸成形 /
- 小针刀
Abstract: Objective To evaluate the clinical efficacy of percutaneous unilateral balloon kyphoplasty combined with small-needle knife treatment in the management of postoperative pain in patients with single-level osteoporotic thoracolumbar compression fractures. Methods A total of 46 patients with single-level osteoporotic thoracolumbar compression fractures who were admitted to the second orthopaedic department of our hospital, Chuzhou Integrated Chinese and Western Medicine Hospital, from July 2017 to March 2019, and met the inclusion and exclusion criteria were selected for this study. General information such as age, sex, and vertebral segment was recorded. The VAS scores were recorded pre-operatively, 24 hours pre-operatively, after needle-knife treatment and at 6 months post-operatively. The Cobb angle before and after surgery and the occurrence of neurological symptoms and recurrent compression fractures within 6 months, were also recorded. Results Post-operative pain was significantly improved compared to pre-operative pain in all 46 patients. The differences in VAS scores and Cobb angles before and after surgery were statistically significant [(2.63±0.74) points vs. (7.30±0.66) points, (8.78±0.16) ° vs. (15.52±0.27) °, all P<0.05]. One case of bone cement overflow occurred and there were no complications such as cardiopulmonary system or lower extremity thrombosis or deaths. Conclusion Percutaneous unilateral balloon kyphoplasty combined with small-needle knife treatment is effective in reducing pain and improving the quality of life in elderly patients with single-level osteoporotic compression fractures. It is considered a safe procedure.
- Osteoporotic thoracolumbar compression fracture /
- Percutaneous kyphoplasty /
- Small needle knife

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图 1 L₁椎体骨折患者PKP手术前后MRI

注：A为术前MRI示L₁椎体骨折; B、C为术后复查腰椎正侧位片示L₁椎体骨水泥填充; D为术后半年随访MRI示L₁椎体高度无明显丢失。

Figure 1. MRI before and after PKP surgery in patients with L₁ vertebral fracture

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图 2 T₁₂椎体骨折患者PKP手术前后MRI

A为术前MRI示T₁₂椎体骨折; B、C为术后复查腰椎正侧位片示T₁₂椎体骨水泥填充; D为术后半年随访MRI示T₁₂椎体高度无明显丢失。

Figure 2. MRI before and after PKP surgery in patients with T12 vertebral fractures

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