椎体成形术和椎弓根螺丝钉治疗胸腰椎椎体压缩性骨折的临床研究

目的:探讨胸腰椎椎体压缩性骨折采用椎体成形术和椎弓根螺丝钉固定的临床疗效。方法:按照随机数字表法将2012年2月~2014年2月我院收治的胸腰椎椎体压缩性骨折患者分为两组,观察组行经皮椎体成形术,对照组行椎弓根螺丝钉固定,术后比较两组的临床疗效及安全性。结果:观察组手术时间、术中出血量、住院时间少于对照组,差异有统计学意义(P<0.01),两组治疗前VAS评分、Cobb角、椎体前缘高度比较,差异无统计学意义(P>0.05),治疗后的VAS评分、Cobb角、椎体前缘高度较治疗前均有所改善,观察组改善程度明显优于对照组,差异有统计学意义(P<0.01);术后两组不良反应主要有伤口感染,症状复发,脊髓损伤,肺栓塞,恶心、呕吐等,观察组症状复发率,恶心、呕吐发生率低于对照组,差异有统计学意义(P<0.05)。结论:胸腰椎椎体压缩性骨折行经皮椎体成形术具有疗效好,并发症少等特点,临床有重要参考价值。

Study on Clinical Efficacy of Vertebroplasty and Pedicle Screws in theTreatment of Thoracolumbar Vertebral Compression Fractures

Objective:To investigate the clinical efficacy of percutaneous vertebroplasty and pedicle screw fixation forthoracolumbar vertebral compression fractures.Methods:Patients with thoracolumbar vertebral compression fractures in our hospitalfrom February 2012 to February 201 4 were divided into two groups according to the random number table method, the observation groupunderwent percutaneous vertebroplasty and the control group underwent pedicle screw fixation, the clinical efficacy and safety of the twogroups after operation were compared.Results:The operation time, amount of bleeding, hospitalization time of observation group wereless than those of the control group, the difference was statistically significant (P<0.01); VAS score, Cobb angle, vertebral body height oftwo groups before treatment presented no significant difference (P>0.05); The VAS score, Cobb angle, vertebral body height aftertreatment were improved, the improvement in observation group was larger than that in the control group, the difference was statisticallysignificant (P<0.01); Postoperative adverse reaction in the two groups were wound infection, recurrence of symptoms, spinal cord injury,pulmonary embolism, nausea and vomiting, the symptoms recurrence rate, nausea,vomiting rate of the observation group were ower thanthose of the control group, the differences was statistically significant (P<0.05).Conclusion:Percutaneous vertebroplasty has thecharacteristics of curative effect and less complications in the treatment of thoracolumbar vertebral compression fractures, and it hasimportant reference value.