CAJ | 학술논문

骨关节植入物%骨损伤基础实验%骨质疏松%支柱块%椎体后凸成形%胸腰椎压缩骨折%球囊扩张%椎体前缘高度%失椎体高度%疼痛%目测类比评分%Cobb 角骨關節植入物%骨損傷基礎實驗%骨質疏鬆%支柱塊%椎體後凸成形%胸腰椎壓縮骨摺%毬囊擴張%椎體前緣高度%失椎體高度%疼痛%目測類比評分%Cobb 角
골관절식입물%골손상기출실험%골질소송%지주괴%추체후철성형%흉요추압축골절%구낭확장%추체전연고도%실추체고도%동통%목측류비평분%Cobb 각
bone and joint implants%basic experiment of bone injury%osteoporosis%pil ar block%kyphoplasty%thoracolumbar vertebral compression fractures%bal oon dilatation%anterior vertebral height%vertebral height%pain%visual analog scale%Cobb angle

背景:“支柱块”置入与球囊扩张椎体成形均可以克服传统后路钉棒系统复位后“空壳样”椎体这一缺点,弥补传统椎弓根钉棒系统固定治疗的不足,并对伤椎本身畸形有不同程度的矫正作用,恢复其承载能力及维持其稳定性.但二者疗效那个更好呢?目的:比较“支柱块”置入与球囊扩张椎体成形术治疗老年胸腰椎骨质压缩骨折的疗效.方法:老年胸腰椎骨质压缩骨折分别采用“支柱块”植入治疗18例,球囊扩张椎体成形治疗76例,对手术时间、失血量、24 h 目测类比评分、7 d 目测类比评分、伤椎前缘高度、Cobb 角等指标进行对比分析.结果与结论:“支柱块”置入治疗18例,球囊扩张椎体成形治疗76例患者经皮穿刺均获成功.”支柱块”置入后患者疼痛目测类比评分、Cobb 角显著减少,椎体前缘高度明显增加,与置换前比较差异有显著性意义(P <0.05).“支柱块”置入与球囊扩张组比较手术时间稍长、失血量稍多、24 h 目测类比评分高,差异有显著性意义(P <0.05),而伤椎前缘高度、7 d 目测类比评分比较,差异无显著性意义(P >0.05).“支柱块”置入未出现不良反应,椎体成形组有骨水泥渗漏现象但均无神经症状.说明“支柱块”置入和经皮椎体后凸成形治疗胸腰椎压缩骨折均具有手术方法简单、手术时间短、术中出血少、能改善椎体高度,缓解疼痛等优点,是治疗胸腰椎压缩骨折安全有效的方法.
배경:“지주괴”치입여구낭확장추체성형균가이극복전통후로정봉계통복위후“공각양”추체저일결점,미보전통추궁근정봉계통고정치료적불족,병대상추본신기형유불동정도적교정작용,회복기승재능력급유지기은정성.단이자료효나개경호니?목적:비교“지주괴”치입여구낭확장추체성형술치료노년흉요추골질압축골절적료효.방법:노년흉요추골질압축골절분별채용“지주괴”식입치료18례,구낭확장추체성형치료76례,대수술시간、실혈량、24 h 목측류비평분、7 d 목측류비평분、상추전연고도、Cobb 각등지표진행대비분석.결과여결론:“지주괴”치입치료18례,구낭확장추체성형치료76례환자경피천자균획성공.”지주괴”치입후환자동통목측류비평분、Cobb 각현저감소,추체전연고도명현증가,여치환전비교차이유현저성의의(P <0.05).“지주괴”치입여구낭확장조비교수술시간초장、실혈량초다、24 h 목측류비평분고,차이유현저성의의(P <0.05),이상추전연고도、7 d 목측류비평분비교,차이무현저성의의(P >0.05).“지주괴”치입미출현불량반응,추체성형조유골수니삼루현상단균무신경증상.설명“지주괴”치입화경피추체후철성형치료흉요추압축골절균구유수술방법간단、수술시간단、술중출혈소、능개선추체고도,완해동통등우점,시치료흉요추압축골절안전유효적방법.
@@@@BACKGROUND: Pil ar implantation and percutaneous bal oon kyphoplasty can overcome the drawbacks of “shel -like” vertebral after traditional posterior screw and rod system reset, make up the lack of traditional pedicle screw and rod system fixation, correct the deformity of the fractured vertebra with varying degrees, recover the carrying capacity and maintain the stability. But, which has the better efficacy has not been yet clear. OBJECTIVE: To compare the clinical effects of Pil ar implantation and percutaneous bal oon kyphoplasty for the elderly thoracolumbar vertebral compression fractures. METHODS: Pil ar implantation was performed in 18 patients with elderly thoracolumbar vertebral compression fractures, percutaneous bal oon kyphoplasty was performed in 76 patients with elderly thoracolumbar vertebral compression fractures. The operative time, blood loss, 24 hours visual analogue scale score, 7 days visual analogue scale score, anterior vertebral height and the Cobb angle were analyzed retrospectively. RESULTS AND CONCLUSION: Both Pil ar implantation in 18 patients and percutaneous bal oon kyphoplasty in 76 patients were successed. The visual analogue scale score and Cobb angle after Pil ar implantation were decreased, but the anterior vertebral height was increased significantly, and there was significant difference of anterior vertebral height when compared with that before implantation (P < 0.05). Compared with percutaneous kyphoplasty, the Pil ar implantation showed longer operative time, more blood loss and higher 24 hours visual bal oon analogue scale score, and the differences were significant (P < 0.05). However, there were no significant differences in anterior vertebral height and 7 days visual analogue scale score between Pil ar implantation group and percutaneous bal oon kyphoplasty group (P > 0.05). There was no adverse reaction after Pil ar implantation, and cement leakage could be observed in percutaneous bal oon kyphoplasty group and no neurosis could be observed. Pil ar implantation and percutaneous bal oon kyphoplasty for the treatment of elderly thoracolumbar vertebral compression fractures have the advantages of simple operation, shorter operative time and less blood loss, and it can improve the anterior vertebral height and relieve the pain, which is considered as the effective method for the treatment of thoracolumbar vertebral compression fractures.