不同复位策略结合经皮椎体成形术治疗老年单节段胸腰椎骨质疏松性椎体压缩性骨折

目的 探讨不同复位策略结合经皮椎体成形术（PVP）治疗老年单节段胸腰椎骨质疏松性椎体压缩性骨折（OVCF）的临床疗效。方法 2019年3月—2021年3月，海军军医大学长征医院收治老年单节段胸腰椎OVCF患者84例，其中54例采取手法复位结合PVP治疗（手法复位组），30例采用单纯PVP治疗（传统组）。记录术中骨水泥注入量及术后骨水泥渗漏情况；测量手术前后伤椎Cobb角及伤椎前缘高度，计算伤椎前缘高度恢复率；采用疼痛视觉模拟量表（VAS）评分评价疼痛程度。结果 所有手术顺利完成，患者随访> 12个月。手法复位组术中骨水泥注入量明显大于传统组，差异有统计学意义（P < 0.05）；但2组骨水泥渗漏率差异无统计学意义（P > 0.05）。2组术后伤椎Cobb角、伤椎前缘高度及VAS评分较术前显著改善，手法复位组改善情况优于传统组，差异均有统计学意义（P < 0.05）。结论 手法复位结合PVP治疗老年单节段胸腰椎OVCF临床效果良好，可更有效地恢复椎体高度，维持脊柱序列稳定性，改善患者临床症状。

Different reduction strategies combined with percutaneous vertebroplasty for treatment of single-segment thoracolumbar osteoporotic vertebral compression fractures in elderly

Objective To investigate the clinical efficacy of different reduction strategies combined with percutaneous vertebroplasty(PVP) in the treatment of single-segment thoracolumbar osteoporotic vertebral compression fractures(OVCF) in the elderly. Methods From March 2019 to March 2021,84 elderly patients with single-segment thoracolumbar OVCF were treated in Changzheng Hospital,of which 54 cases were treated with manual reduction combined with PVP(manual reduction group),and 30 with simple PVP(traditional group). The amount of bone cement injected during operation and the leakage of bone cement after operation were recorded;the Cobb angle and anterior height of injured vertebra were measured before and after operation,and the recovery rate of anterior height of injured vertebra was calculated;the visual analogue scale(VAS) was used to evaluate the pain intensity. Results All the operations were successfully completed,and the patients were followed up for more than 12 months. The amount of bone cement injected in manual reduction group was significantly higher than that in traditional group,with a statistical significance(P < 0.05),but there was no significant difference between the 2 groups in bone cement leakage rate(P > 0.05). The Cobb angle of injured vertebra,anterior height of injured vertebra and VAS score were significantly improved in both groups after operation compared with those before operation,and the improvement in manual reduction group was better than that in traditional group,with a statistical significance(P < 0.05). Conclusion Manual reduction combined with PVP has a good clinical effect in the treatment of elderly single-segment thoracolumbar OVCF,which can more effectively restore the height of the vertebral body,maintain the stability of the spinal sequence,and improve the clinical symptoms of patients.