摘要
目的:分析创伤性胸腰椎椎体压缩性骨折患者采用经皮椎体后凸成形术治疗的效果,以及其对术后疼痛、功能恢复的影响。方法:回顾性分析2023年1月—2024年6月徐州医科大学附属医院收治的80例创伤性胸腰椎椎体压缩性骨折患者临床资料,按照治疗方案的不同将其分为对照组和研究组,各40例。对照组接受切开复位椎弓根固定术治疗,研究组接受经皮椎体后凸成形术治疗。比较两组围手术期指标、疼痛程度、功能恢复情况、椎体状态、炎症指标及骨密度、并发症发生情况。结果:研究组术中出血量少于对照组,手术操作时间、术后首次功能训练时间、术后首次下床活动时间均短于对照组,差异均有统计学意义(P<0.05)。术后3个月,两组疼痛视觉模拟法评分均低于术前,且研究组低于对照组,差异均有统计学意义(P<0.05)。术后3个月,两组Oswestry功能障碍指数评分均低于术前,且研究组低于对照组,腰椎日本骨科协会评分均高于术前,且研究组高于对照组,差异均有统计学意义(P<0.05)。术后3个月,两组Cobb角均小于术前,且研究组小于对照组,两组椎体中柱及前柱高度均高于术前,且研究组均高于对照组,差异均有统计学意义(P<0.05)。术后3个月,两组肿瘤坏死因子-α、白细胞介素-6水平均低于术前,且研究组均低于对照组,两组下腰椎密度、股骨头密度均大于术前,且研究组均大于对照组,差异均有统计学意义(P<0.05)。对照组并发症发生率为10.00%,与研究组的7.50%比较,差异无统计学意义(P>0.05)。结论:在对创伤性胸腰椎椎体压缩性骨折患者进行治疗时,选择经皮椎体后凸成形术治疗不仅能减少术中出血量,缩短康复时间,而且能减轻术后疼痛,改善运动功能及椎体状态,同时还能减轻炎症反应,提高骨密度,具有一定安全性。
Objective:To analyze the therapeutic effect of percutaneous kyphoplasty in patients with traumatic thoracolumbar vertebral compression fractures,as well as its influence on postoperative pain and functional recovery.Methods:A retrospective analysis was conducted on the clinical data of 80 patients with traumatic thoracolumbar compression fractures admitted to the Affiliated Hospital of Xuzhou Medical University from January 2023 to June 2024.They were divided into a control group and a study group according to different treatment regimens,with 40 cases in each group.The control group received open reduction and pedicle fixation treatment,while the study group received percutaneous kyphoplasty treatment.The perioperative indicators,pain degree,functional recovery,vertebral body status,inflammatory indicators,bone mineral density and the occurrence of complications were compared between the two groups.Results:The intraoperative blood loss in the study group was less than that in the control group,the operation time,the first postoperative functional training time,and the time for the first postoperative ambulation in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).Three months after the operation,the Pain Visual Analogue Scale scores of both groups were lower than those before the operation,and the score of the study group was lower than that of the control group,the differences were statistically significant(P<0.05).Three months after the operation,the Oswestry Disability Index scores of both groups were lower than those before the operation,and the score of the study group was lower than that of the control group,the lumbar Japanese Orthopaedic Association score of both groups were higher than those before the operation,and the score of the study group was higher than that of the control group,the differences were statistically significant(P<0.05).Three months after the operation,the Cobb angles in both groups were smaller than those before the operation,and those in the study group were smaller than those in the control group,the heights of the vertebral midcolumn and anterior column in both groups were higher than those before the operation,and those in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Three months after the operation,the levels of tumor necrosis factor-αand interleukin-6 in both groups were lower than those before the operation,and the levels in the study group were lower than those in the control group,the densities of the lower lumbar vertebrae and femoral head in both groups were bigger than those before the operation,and the levels in the study group were bigger than those in the control group, the differences were statistically significant (P<0.05). The incidence of complications in the control group was 10.00%, compared with 7.50% in the study group, the difference was not statistically significant (P>0.05). Conclusion: When treating patients with traumatic thoracolumbar vertebral compression fractures, percutaneous kyphoplasty can not only reduce intraoperative blood loss and shorten the recovery time, but also alleviate postoperative pain, improve motor functional and vertebral conditions. At the same time, it can also reduce inflammatory responses and increase bone mineral density, and has certain safety.
作者
李成宇
张帆
LI Chengyu;ZHANG Fan(Department of Orthopaedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国伤残医学》
2025年第9期51-55,60,共6页
Chinese Journal of Trauma and Disability Medicine
关键词
创伤性胸腰椎椎体压缩性骨折
经皮椎体后凸成形术
术后疼痛
功能恢复
Traumatic thoracolumbar vertebral compression fracture
Percutaneous kyphoplasty of vertebral body
Postoperative pain
Functional recovery
