经皮椎弓根螺钉内固定联合椎体成形术治疗Genant Ⅲ度骨质疏松性椎体压缩骨折
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作者Author单位AddressE-Mail
李志鲲 LI Zhi-kun 上海交通大学医学院附属同仁医院骨科, 上海 200336
苏州大学附属第二医院骨科, 江苏 苏州 215000
Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China  
徐又佳 XU You-jia 苏州大学附属第二医院骨科, 江苏 苏州 215000  
徐炜 XU Wei 上海交通大学医学院附属同仁医院骨科, 上海 200336 Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China weixu@shsmu.edu.cn 
朱晓东 ZHU Xiao-dong 上海交通大学医学院附属同仁医院骨科, 上海 200336 Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China  
李光飞 LI Guang-fei 苏州大学附属第二医院骨科, 江苏 苏州 215000  
陈超 CHEN Chao 上海交通大学医学院附属同仁医院骨科, 上海 200336 Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China  
李一凡 LI Yi-fan 上海交通大学医学院附属同仁医院骨科, 上海 200336 Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China  
王奕 WANG Yi 上海交通大学医学院附属同仁医院骨科, 上海 200336 Department of Orthopaedics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336, China  
期刊信息:《中国骨伤》2020年,第33卷,第9期,第807-813页
DOI:10.12200/j.issn.1003-0034.2020.09.004
基金项目:上海市卫生计生系统优秀青年医学人才培养计划(编号:2018YQ46);长宁区科委科研课题(编号:CNKW2018Y10);上海市卫健委课题(编号:201640233);上海交通大学医工交叉研究基金(编号:YG2017MS66,YG2016MS68)
中文摘要:目的:探讨经皮椎弓根螺钉内固定(percutaneous pedicle screw fixation,PPSF)联合椎体成形术(percuta-neous vertebroplasty,PVP)治疗Genant Ⅲ度骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)的临床疗效。

方法:对2015年6月至2017年6月使用PPSF联合PVP治疗的83例Genant Ⅲ度OVCFs患者(联合组)进行回顾性分析,其中男19例,女64例,年龄(73.6±11.0)岁。并选取2013年1月至2015年6月行单纯PVP治疗的83例患者作为对照组,男15例,女68例,年龄(75.5±10.6)岁。对比两组患者术前,术后1 d,术后6、12、24个月的椎体前缘高度及Cobb角;采用视觉模拟评分(visual analogue scale,VAS)和腰痛功能障碍指数(Oswestry Disability Index,ODI)分别对两组患者的疼痛程度和日常腰椎活动功能障碍进行评估,并观察并发症。

结果:所有患者的随访时间>2年,联合组和对照组分别为(24.3±10.2)个月及(27.5±14.8)个月。两组患者术后1 d伤椎前缘高度、Cobb角比较差异无统计学意义(P>0.05),术后6、12、24个月伤椎前缘高度、Cobb角组间比较差异均有统计学意义(P<0.01)。两组患者术后6、12个月的ODI及VAS评分比较差异均有统计学意义(P<0.05)。对照组术后并发症高于联合组。

结论:PPSF联合PVP治疗Genant Ⅲ度OVCFs在椎体高度丢失、患者满意度及并发症方面优于单纯PVP。
【关键词】经皮椎弓根螺钉内固定  经皮椎体成形术  骨质疏松性椎体压缩骨折
 
Percutaneous pedicle screw fixation combined with vertebroplasty for the treatment of Genant Ⅲ degree osteoporotic vertebral compression fractures
ABSTRACT  Objective: To investigate the clinical effect of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of Genant Ⅲ degree osteoporotic vertebral compression fractures (OVCFs).

Methods: The hospitalized 83 patients with Genant Ⅲ degree OVCFs treated by PPSF combined with PVP from June 2015 to June 2017 were retrospectively analyzed,and 83 patients treated by PVP alone from January 2013 to June 2016 were randomly selected as the control group. There were 19 males and 64 females with an average age of (73.6±11.0) years in combined group with treatment of PPSF and PVP. There were 15 males and 68 females with an average age of (75.5±10.6) years in control group. The anterior edge height of the vertebral body and Cobb angle before operation,1 day,and 6,12,24 months after operation were compared between two groups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess the pain level and daily lumbar dysfunction for patients,respectively. The complications were observed.

Results: The follow-up time of all patients was more than 2 years. The combined group and control group were (24.3±10.2) months and (27.5±14.8) months,respectively. There were no statistically significant differences in the anterior edge height of the vertebral body and Cobb angle at 1 day after surgery between two groups (P>0.05),and there were statistically significant differences at 6,12,24 months after surgery between two groups (P<0.01). The difference in ODI and VAS scores at 6 and 12 months after operation between two groups was statistically significant (P<0.05). Postoperative complications in control group were higher than those in the combined group.

Conclusion: PPSF combined with PVP for the treatment of Genant Ⅲ degree OVCFs is superior to PVP alone in terms of vertebral height loss,patient satisfaction,and complications.
KEY WORDS  Percutaneous pedicle screw fixation  Percutaneous vertebroplasty  Osteoporotic vertebral compression fractures
 
引用本文,请按以下格式著录参考文献:
中文格式:李志鲲,徐又佳,徐炜,朱晓东,李光飞,陈超,李一凡,王奕.经皮椎弓根螺钉内固定联合椎体成形术治疗Genant Ⅲ度骨质疏松性椎体压缩骨折[J].中国骨伤,2020,33(9):807~813
英文格式:LI Zhi-kun,XU You-jia,XU Wei,ZHU Xiao-dong,LI Guang-fei,CHEN Chao,LI Yi-fan,WANG Yi.Percutaneous pedicle screw fixation combined with vertebroplasty for the treatment of Genant Ⅲ degree osteoporotic vertebral compression fractures[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(9):807~813
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