摘要
目的探讨布带上提法结合经皮椎体后凸成形术（PKP）治疗重度椎体压缩性骨折的技巧及疗效。方法应用布带上提法结合PKP治疗重度椎体压缩性骨折28例。术前应用布带条兜着患者椎体骨折后凸处上提，使脊柱极度过伸纠正部分脊柱后凸畸形，然后在过伸体位下行PKP，术后严密观察患者生命体征的变化、疼痛缓解状况与骨折复位情况。结果28例患者均顺利完成手术，术后6～8h疼痛迅速缓解，术后1～2d均能下床活动。椎体高度由术前的（4．90±0．13）cm增加至术后3d的（15．20±0．25）cm，Cobb角由术前的31．00°±2．80°矫正至术后的18．20°±2．80°，疼痛视觉模拟评分（VAS）由术前的（7．10±1．36）分降至术后3d的（1．20±0．90）分，治疗前后各指标差异有统计学意义（P〈0．01）。术中发生骨水泥渗漏2例，1例为椎间盘漏，1例为椎体侧方漏。无严重并发症发生。结论布带上提法结合PKP治疗重度椎体压缩性骨折，是一种较为简单、安全、损伤小的有效方法，在止痛和纠正脊柱后凸畸形方面具有肯定的效果。布带上提法能够使严重压缩的椎体部分复位，利于术中穿刺，值得推广应用。
Objective To investigate the skills and therapeutic effects of cloth tape formulation combined with percuta- neous kyphoplasty （PKP） in the treatment of severe vertebral compression fracture.Methods 28 cases of patients with severe vertebral compression fracture were treated by cloth tape formulation combined with PKP.Before operation, kyphosis of fracture in vertebral body was lifted by bandage to extremely extend the vertebral column in order to partly correct kyphosis of the column.PKP was then performed in the hyperextension position.The vital signs,pain alleviation, and reduction of fracture were closely observed after surgery.Results The operations were successful in all patients who alleviated pain 6 to 8 h after surgery and were off bed 1 to 2 days after treatment.The height of vertebral body in creased from （4.90±0.13） cm to （15.20±0.25） em in the third day after surgery.The Cobb angle was reduced from 31.00°±2.80° to 18.20°±2.80°.The visual analogue scale （VAS） was dropped from （7.10±1.36） point to （1.20±0.90） point in the third day after surgery.The indicators mentioned above all displayed statistical differences before and after surgery （P〈 0.01）.There was no severe complication occurred except 2 cases presenting with leakage of bone cement in interverte- hral disc and vertebral side respectively.Conclusion In the treatment of severe vertebral compression fracture,cloth tape formulation combined with PKP,at advantages of simpleness,safety,and little wound,can obtain definite effects on reliev- ing pain and correcting kyphosis of vertebral column.The cloth tape formulation can partly restore the severe vertebral compression fracture and is beneficial for intraoperative puncture,which is worthy of expansion.
出处
《中国当代医药》
2014年第7期34-37,共4页
China Modern Medicine
关键词
椎体后凸成形术
布带上提法
椎体压缩性骨折
Percutaneous kyphoplasty,Cloth tape formulation
Vertebral compression fracture
