微创医学2024，Vol.19Issue(5)：484-491,8.DOI:10.11864/j.issn.1673.2024.05.02
经皮椎弓根螺钉联合伤椎植骨或伤椎后凸成形术治疗骨质疏松性胸腰椎爆裂骨折的效果比较
Effect of percutaneous pedicle screw combined with injured vertebral bone grafting or injured vertebral kyphoplasty in the treatment of osteoporotic vertebral burst fractures:a comparative study
摘要
Abstract
Objective To investigate the clinical efficacy of percutaneous pedicle screw combined with injured vertebral bone grafting and percutaneous pedicle screw combined with injured vertebral kyphoplasty in the treatment of osteoporotic vertebral burst fractures(OVBF)without neurological symptoms.Methods A total of 72 patients with OVBF without neurological symptoms were selected as research objects.According to the treatment methods,patients treated with percutaneous pedicle screw combined with injured vertebral bone grafting were included in the observation group(n=37),and patients treated with percutaneous pedicle screw combined with kyphoplasty of the injured vertebrae were included in the control group(n=35).Perioperative indexes of the two groups were compared,including operation time,intraoperative blood loss,occurrence of intraoperative complications,postoperative postoperative ambulation time and hospital stay,as well as pain visual analogue scale(VAS)score,Oswestry disability index(ODI)score,Cobb Angle of kyphosis,anterior vertebral height(AVH)ratio and thoracolumbar kyphosis(TLK)at 1 day before operation,7 days,6 months and 26 months after operation,and the bony union and occurrence of postoperative complications at 26 months after operation.Results There were no statistically significant differences in the ambulation time and hospital stay between the two groups(all P>0.05).Compared with the control group,the observation group had higher intraoperative blood loss,longer operation time and lower incidence of bone cement leakage,with statistically significant differences(all P<0.05).The VAS score of the observation group was higher than that of the control group at 7 days after operation,and the ODI score of the observation group was lower than that of the control group at 6 months and 26 months after operation(all P<0.05).There were no statistically significant differences in the Cobb Angle of kyphosis,AVH ratio and TLK between the two groups at 7 days,6 months and 26 months after operation(all P>0.05).At the last follow-up,both groups of patients achieved bony union after vertebral bone grafting.There were no postoperative complications in the observation group,and the incidence of postoperative complications was significantly lower than that in the control group(P<0.05).Conclusion Both percutaneous pedicle screw combined with injured vertebral bone grafting and percutaneous pedicle screw combined with injured vertebral kyphoplasty are safe and effective minimally invasive surgical methods for the treatment of OVBF without neurological symptoms.However,percutaneous pedicle screw combined with injured vertebral bone grafting has fewer complications,can maintain the stability of postoperative internal fixation,and reduce the risk of internal fixation loosening and failure,which is worthy of clinical promotion.关键词
骨质疏松症/胸腰椎/爆裂骨折/经皮椎弓根螺钉/植骨/后凸成形Key words
Osteoporosis/Thoracolumbar spine/Burst fractures/Percutaneous pedicle screw/Bone grafting/Percutaneous kyphoplasty引用本文复制引用
覃忠设,陈勇喜,覃海飚,郭圣挥,刘科第,蒙觉威,范俊鸿,崔善林..经皮椎弓根螺钉联合伤椎植骨或伤椎后凸成形术治疗骨质疏松性胸腰椎爆裂骨折的效果比较[J].微创医学,2024,19(5):484-491,8.基金项目
广西中医药适宜技术开发与推广项目(编号:GZSY23-28) （编号:GZSY23-28）
广西中医药大学校级课题(编号:2022MS043) （编号:2022MS043）
