| 摘要: |
| 目的：比较经皮椎体后凸成形术（percutaneous kypho plasty，PKP）配合正骨手法治疗骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fractures，OVCF）伴椎体内裂隙样变（intravertebral vacuumcleft，IVC）的疗效。方法：选择 OVCF 伴 IVC 患者 86 例，按照随机数字表法分为治疗组和对照组，对照组给予 PKP 治疗，治疗组在对照组基础上给予正骨手法治疗。分别于术前、术后 1 周、术后 1 个月、术后 6 个月采用疼痛视觉模拟量表（VAS）评分、Oswestry 功能障碍指数（ODI）评价疼痛缓解及功能改善程度；采用影像学对伤椎高度、后凸 Cobb 角进行对比。结果：两组治疗前后椎前缘高度、Cobb 角、VAS 评分、ODI 评分组间、治疗前后、交互作用经重复测量分析差异均有统计学意义（P<0.001）；两组渗漏率差异无统计学意义（χ2=1.325，P=0.433>0.05）。结论：PKP 配合正骨手法治疗 OVCF 伴 IVC，能够恢复椎体的顺应性、维持脊柱稳定性、提高患者生存质量，且安全性高。 |
| 关键词: 骨质疏松 椎体压缩骨折 裂隙样变 经皮椎体后凸成形术 正骨手法 |
| DOI：10.3969/j.issn.1007-6948.2019.02.009 |
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| 基金项目:陕西省社会发展科技攻关项目（2016SF-187） |
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| Clinical Research on Percutaneous Kyphoplasty Combined with Bone-setting Manipulation in Treatment of Osteoporotic Vertebral Compression Fractures and Intravertebral Vacuumcleft |
| ZHAO Xiao-ming,CHEN Chang-chun |
| Department of Orthopaedics, Baoji Central Hospital, Baoji (721008), China |
| Abstract: |
| Objectives To compare the ef?cacy of percutaneous kyphoplasty (PKP) combined with bone- setting manipulation in treatment of osteoporotic vertebral compression fractures (OVCF) and intravertebral vacuumcleft (IVC), and explore the mechanism. Methods The patients (86 cases) with OVCF and IVC who visited the orthopedics department were selected and divided into experimental group and control group according to the random number table, each group had 43 cases. The patients in control group were treated with PKP, and the patients in experimental group were given bone-setting manipulation on the basis of the control group. Visual-analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the pain relief and functional improvement before surgery, 1 week after surgery, 1 month after surgery and 6 months after surgery; the height of injured vertebral and angle of Cobb were compared by imaging. Results Frontal height, Cobb angle, VAS score and ODI score before and after treatment between two groups were statistically signi?cant different. The interaction was analyzed by repeated measurements and the difference was statistically signi?cant (P<0.001). There was no statistically significant difference in total leakage rate between the two groups in postoperative (χ2=1.325，P =0.433>0.05). Conclusion PKP combined with bone-setting manipulation can restore the compliance of vertebral body, maintain the stability of spine, improve the quality of life of patients, and has high safety, which is worthy of clinical promotion. |
| Key words: Osteoporosis vertebral compression fractures intravertebral vacuumcleft percutaneous kyphoplasty bone-setting manipulation |
