中国骨伤2025，Vol.38Issue(2)：134-140,7.DOI:10.12200/j.issn.1003-0034.20230937
伤椎单侧置钉结合骨水泥强化与伤椎双侧置钉治疗骨质疏松性胸腰椎骨折的疗效比较
Comparison of the efficacy of unilateral nailing combined with bone cement reinforcement and bilateral nailing in the treatment of osteoporotic thoracolumbar fractures
楼宇梁 1陈国英 1王灿锋 1费慧 1孙观荣 1全仁夫 1李伟 1洪锋1
作者信息
- 1. 杭州市萧山区中医院骨科,浙江 杭州 311201
- 折叠
摘要
Abstract
Objective To compare the efficacy of percutaneous pedicle screw combined with unilateral nail placement combined with bone cement strengthening and bilateral nail placement in the treatment of osteoporotic thoracic and lumbar fractures.Methods A retrospective case-control study was used to analyze the clinical data of 78 patients with osteoporotic tho-racic and lumbar fractures admitted from October 2017 to May 2019.According to the surgical method,it was divided into per-cutaneous pedicle screw combined with unilateral nail placement combined with unilateral bone cement strengthening group(bone cement group)and percutaneous pedicle screw combined with bilateral nail placement(screw group).In the bone ce-ment group,40 patients included 16 males and 24 females,with a mean age of(62.1±8.1)years old.In the screw group,38 patients included 18 males and 20 females with a mean age of(65.1±9.3)years old.The operation time,intraoperative blood loss,length of hospital stay and postoperative complications were compared between two groups.The kyphosis Cobb angle,an-terior edge height ratio,central height ratio and pain visual analogue score(VAS)were compared.Results All patients were followed up for 25 to 36 months.The operation time(70.1±17.3)min of the cement group was shorter than that of the screw group(78.6±18.2)min(P＜0.05).There were no significant differences in intraoperative blood loss and length of hospital stay(P＞0.05).The VAS in the cement group 1 year 1.5±0.5 and the latest follow-up 0.5±0.3 after operation were lower than 1 year 1.8±0.3 and the latest follow-up 0.8±0.4 in the screw group(P＜0.05).The kyphosis Cobb angle,anterior edge height ratio,cen-tral height ratio in bone cement group,1 year(6.2±1.2)°,(86.6±3.5)％,(91.1±2.5)％,the last follow-up(6.4±0.7)°,(85.5±3.3)％,(90.5±6.3)％were better than that of the screw group 1 year(6.8±1.4)°,(83.1±2.4)％,(89.9±3.4)％and the latest follow-up(7.1±1.1)°,(82.6±4.1)％,(87.6±5.9)％(P＜0.05).There were 3 cases of bone cement leakage in the cement group,all of which had no clinical symptoms;and 2 cases of pedicle screws were extracted in the screw group,and the screws were re-moved at the last follow-up.Conclusion Percutaneous pedicle screw combined with unilateral nail placement combined with bone cement strengthening and bilateral nail placement in the treatment of osteoporotic thoracic and lumbar compression frac-tures in the elderly can achieve satisfactory efficacy and effectively relieve the pain of patients,but the former internal fixation system is more stable,and the long-term follow-up can effectively maintain the height of the anterior middle column and the correction of kyphosis deformity,and the incidence of chronic low back pain is lower.关键词
骨质疏松性骨折/胸椎/腰椎/脊柱骨折/手术治疗Key words
Osteoporotic fractures/Thoracic vertebra/Lumbar vertebrae/Spine fractures/Surgical treatment分类
临床医学引用本文复制引用
楼宇梁,陈国英,王灿锋,费慧,孙观荣,全仁夫,李伟,洪锋..伤椎单侧置钉结合骨水泥强化与伤椎双侧置钉治疗骨质疏松性胸腰椎骨折的疗效比较[J].中国骨伤,2025,38(2):134-140,7.
