1.SIAN INTERNATIONAL HOSPITAL;2.新安国际医院;3.宁夏中医医院暨中医研究院
目的：探讨采用三点复位联合经皮球囊扩张后凸椎体成形术（percutaneous kyphoplasty，PKP）治疗伴椎体后壁破裂胸腰椎骨质疏松性椎体压缩骨折 ( osteoporotic vertebral compression fracture，OVCF)的安全性和有效性。方法：回顾性分析2019年1月至2020年10月我院收治的95例OVCF患者，其中伴有椎体后壁破裂OVCF有12例（破裂组），无后壁破裂OVCF有83例（未破裂组）。两组患者均先采用三点复位，再行PKP技术治疗。记录并比较两组患者一般资料（年龄、性别、节段等）、围手术期资料（复位时间、透视次数、骨水泥渗漏等）、术前及术后腰痛视觉模拟评分（Visual Analogue Scale,VAS）、Oswestry功能障碍指数（Oswestry Disability Index,ODI）以及伤椎椎体前缘高度、局部Cobb角（o）等情况。结果：两组患者术前VAS 评分、ODI与术后各时间点相应指标对比均显著降低（P<0.05）。所有患者顺利完成手术，均无严重手术并发症发生。两组术后均发生骨水泥渗漏，且骨水泥渗漏率无统计学差异（p>0.05）。两组椎体前缘高度术后均明显升高（P<0.05），局部Cobb角（o）术后明显减少（P<0.05）。结论：三点复位联合PKP技术治疗OVCF安全有效，尤其是伴椎体后壁破裂的OVCF患者，能够恢复椎体高度，缓解疼痛。
Objective: To investigate the safety of three-point reduction combined with percutaneous balloon kyphoplasty (percutaneous kyphoplasty, PKP) in the treatment of thoracolumbar osteoporotic vertebral compression fracture (OVCF) with posterior wall rupture. sex and effectiveness. Methods: A retrospective analysis of 95 patients with OVCF admitted to our hospital from January 2019 to October 2020, including 12 cases of OVCF with posterior vertebral wall rupture (rupture group), and 83 cases of OVCF without posterior wall rupture (no posterior wall rupture). rupture group). The patients in both groups were treated with three-point reduction first and then with PKP technique. The general data (age, gender, segment, etc.), perioperative data (reduction time, fluoroscopy times, bone cement leakage, etc.), preoperative and postoperative low back pain visual analogue scale (Visual Analogue Scale, VAS), Oswestry Disability Index (ODI), anterior height of injured vertebral body, local Cobb angle (o) and so on. Results: The preoperative VAS score and ODI of the two groups were significantly decreased compared with the corresponding indexes at each postoperative time point (P<0.05). All patients successfully completed the operation, and no serious surgical complications occurred. Bone cement leakage occurred in both groups after operation, and there was no statistical difference in the rate of bone cement leakage (p>0.05). The height of the anterior vertebral body in both groups was significantly increased after operation (P<0.05), and the local Cobb angle (o) was significantly decreased after operation (P<0.05). Conclusion: Three-point reduction combined with PKP technique is safe and effective in the treatment of OVCF, especially in patients with OVCF with rupture of the posterior wall of the vertebral body, which can restore the height of the vertebral body and relieve pain.