摘要
目的:探究椎体成形术术中植骨对老年胸腰椎压缩性骨折治疗效果的影响。方法:将2021年9月—2024年1月上海大学附属南通医院的89例老年胸腰椎压缩性骨折行椎体成形术治疗患者根据随机数字表法分为对照组(n=44)与观察组(n=45)。对照组术中未植骨,观察组术中经椎弓根植骨。比较两组的治疗效果(总优良率)、邻近节段骨折发生率、手术前后的疼痛程度(VAS评分)、日常生活能力(Barthel指数评分)、稳定性指标(Cobb角、伤椎前缘高度及伤椎后缘高度)及骨密度。结果:术后6个月,观察组的总优良率显著高于对照组,术后6个月邻近节段骨折发生率显著低于对照组(P<0.05)。术前两组的VAS评分、Barthel指数评分、稳定性指标及骨密度比较,差异无统计学意义(P>0.05);术后1、3、6个月观察组的VAS评分及Cobb角显著低于对照组,Barthel指数评分、伤椎前缘高度及伤椎后缘高度高于对照组(P<0.05)。结论:椎体成形术术中植骨在老年胸腰椎压缩性骨折患者中的应用效果较好,且在改善术后稳定性、日常生活能力,降低疼痛程度及邻近节段骨折发生方面的优势突出。
Objective:To investigate the influence of bone implantation during vertebroplasty for the therapeutic effect of elderly patients with compression fractures of the thoracolumbar spine.Method:A total of 89 elderly patients with compression fractures of the thoracolumbar spine treated with vertebroplasty in Affiliated Nantong Hospital of Shanghai University from September 2021 to January 2024 were divided into the control group(n=44)and the observation group(n=45)by the random number table method.The control group were treated without bone implantation during the operation,the observation group were treated with bone implantation through vertebral pedicle during the operation.The therapeutic effects(total excellent and good rate),the incidence of adjacent segments fractures,the degree of pain before and after surgery(VAS score),the ability of daily living(Barthel index score),stability indicators(Cobb angle,anterior height of the injured vertebra and posterior height of the injured vertebra),and bone mineral density were compared between the two groups.Result:The total excellent and good rate at sixth month after the operation of the observation group was significantly higher than that of the control group,the adjacent segments fracture rate at sixth month after the operation was significantly lower than that of control group(P<0.05).There were no statistically significant differences in the VAS score,Barthel index score,stability index and bone mineral density between the two groups before the operation(P>0.05).At 1 month and 3,6 months after the operation,the VAS scores and Cobb angle of the observation group were significantly lower than those of the control group,while the Barthel index score,anterior height of the injured vertebrae,and posterior height of the injured vertebrae were higher than those of the control group(P<0.05).Conclusion:Bone implantation during vertebroplasty has a good application effect in elderly patients with compression fractures of the thoracolumbar spine,and has prominent advantages in improving postoperative stability,daily living ability,reducing pain degree and the occurrence of adjacent segmental fractures.
作者
周春林
ZHOU Chunlin(Department of Orthopedics,Affiliated Nantong Hospital of Shanghai University,Nantong 226000,China)
出处
《中国医学创新》
2025年第36期85-89,共5页
Medical Innovation of China
关键词
椎体成形术
经椎弓根植骨
胸腰椎压缩性骨折
稳定性
骨密度
Vertebroplasty
Bone implantation through vertebral pedicle
Compression fractures of the thoracolumbar spine
Stability
Bone mineral density
