[1]刘 智,郭树章,王铜浩,等.术中体外手法复位在椎体成型治疗椎体压缩骨折中的疗效观察[J].医学信息,2025,38(09):117-120.[doi:10.3969/j.issn.1006-1959.2025.09.023]
　LIU Zhi,GUO Shuzhang,WANG Tonghao,et al.Observation on the Curative Effect of Intraoperative Manual Reduction in Vitro in the Treatment of Vertebral Compression Fractures with Percutaneous Vertebroplasty[J].Journal of Medical Information,2025,38(09):117-120.[doi:10.3969/j.issn.1006-1959.2025.09.023]
点击复制

术中体外手法复位在椎体成型治疗椎体压缩骨折中的疗效观察()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年09期
页码:
117-120
栏目:
论著
出版日期:
2025-05-01

文章信息/Info

Title:
Observation on the Curative Effect of Intraoperative Manual Reduction in Vitro in the Treatment of Vertebral Compression Fractures with Percutaneous Vertebroplasty
文章编号:
1006-1959（2025）09-0117-04
作者:
刘 智; 郭树章; 王铜浩; 田永刚; 韩立强; 吴凯楠
天津市第三中心医院骨科/天津市重症疾病体外生命支持重点实验室/天津市人工细胞工程技术研究中心/天津市肝胆疾病研究所，天津 300381
Author(s):
LIU Zhi;  GUO Shuzhang;  WANG Tonghao;  TIAN Yonggang;  HAN Liqiang;  WU Kainan
Department of Orthopaedics, the Third Central Hospital of Tianjin/Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases/Artificial Cell Engineering Technology Research Center/Tianjin Institute of Hepatobiliary Disease, Tianjin 300381, China
关键词:
椎体成型; 椎体压缩骨折; 复位; 椎体高度
Keywords:
Vertebroplasty;  Vertebral compression fractures;  Reduction;  Vertebral body height
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2025.09.023
文献标志码:
A
摘要:
目的 探讨椎体成型术治疗老年骨质疏松性椎体压缩骨折（OVCF）时，采用体位复位结合手术中注射骨水泥过程中体外手法复位的治疗效果。方法 收集2022年6月-2023年5月天津市第三中心医院老年（≥60岁）OVCF行经皮椎体成型术治疗时采用术中体外手法复位的病例资料，共31例，随访1个月，测量术前、术后椎体压缩程度、Cobb角，记录患者术前、术后疼痛视觉模拟评分（VAS），观察该方法的疗效。结果 术前、术后椎体压缩程度及伤椎Cobb角、VAS评分比较，差异有统计学意义（P＜0.05）；所有病例无神经损伤及伤口感染、血肿发生。有骨水泥渗漏5例，其中椎间盘渗漏3例，前方渗漏1例，侧方渗漏1例，无椎管内渗漏病例。术中骨水泥注射过程中一过性低血压1例，应用地塞米松2分钟后恢复。结论 体位复位后，在手术中骨水泥推注时另外施加手法复位力，存在持续的复位力，可以获得更加满意的复位效果，降低后凸的残留程度，临床疗效佳。
Abstract:
Objective To discuss the treatment effect of posture hypertension reduction combined with manual reduction during the injection of bone cement in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures in the elderly. Methods The clinical data of 31 elderly patients (≥ 60 years old) with OVCF who underwent percutaneous vertebroplasty in the Third Central Hospital of Tianjin from June 2022 to May 2023 were collected. A total of 31 patients were followed up for 1 month. The degree of vertebral compression and Cobb angle before and after operation were measured, and the visual analogue scale (VAS) of pain before and after operation was recorded to observe the efficacy of this method. Results There were significant differences in vertebral compression degree, Cobb angle and VAS score before and after operation (P<0.05). No nerve injury, wound infection and hematoma occurred in all cases. There were 5 cases of bone cement leakage, including 3 cases of intervertebral disc leakage, 1 case of anterior leakage, 1 case of lateral leakage, and no case of intraspinal leakage. Transient hypotension occurred in 1 case during intraoperative bone cement injection, and recovered after 2 minutes of dexamethasone application. Conclusion After posture hyperextension reduction, the application of additional manual reduction force in the course of bone cement injection provides a continuous reduction force, which can achieve more satisfactory reduction results, reduce the degree of residual kyphosis, and has good clinical efficacy.

参考文献/References:

[1]杨俊松,陈浩,刘鹏,等.椎体成型术后早期腰背部残余疼痛的原因分析[J].中华骨科杂志,2020,40(10):625-634.[2]陈国能,陈扬,陈显辉,等.PKP术后伤椎恢复高度与邻近椎体应力关系的有限元分析[J].中国骨与关节损伤杂志,2019,34(11):1165-1167.[3]王亮,王璨,杨海松,等.不同复位策略结合经皮椎体成型术治疗老年单节段胸腰椎骨质疏松性椎体压缩性骨折[J].脊柱外科杂志,2023,21(3):151-154,161.[4]Yokoyama K,Ikeda N,Tanaka H,et al.The effectiveness of vertebral height restoration based on the vertebroplasty procedure used to treat osteoporotic vertebral fractures[J].Neurospine,2023,20(4):1159-1165.[5]Choi SH,Kim DY,Koo JW,et al.Incidence and management trends ofosteoporotic vertebral compression fractures in South Korea:a nationwide population-based study[J].Asian Spine J,2020,14(2):220-228.[6]Galibert P,Deramond H,Rosat P,et al.Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty[J].Neurochirurgie,1987,33(2):166-168.[7]李康,王诗尧,许少策,等.中国人群PVP术后非手术椎体骨折的危险因素[J].中国脊柱脊髓杂志,2018，28(9):801-810.[8]Jindal V,Binyala S,Kohli SS.Balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral body compression fractures:clinical and radiological outcomes[J].Spine J,2023,23(4):579-584.[9]Galivanche AR,Toombs C,Adrados M,et al.Cement augmentation of vertebral compression fractures may be safely considered in the very elderly[J].Neurospine,2021,18(1):226-233.[10]李庆达,高林,惠华,等.经皮椎体成形术Ⅰ期治疗急性多节段老年骨质疏松性胸腰椎压缩骨折[J].中华创伤杂志,2021,37(4):318-325.[11]Pradhan BB,Bae HW,Kropf MA,et al.Kyphoplasty reduction of osteoporotic vertebral compression fractures:correctionoflocalkyphosisversusoverallsagittalalignment[J].Spine(PhilaPa 1976),2006,31(4):435-441.[12]李元,李立平,李强.PKP治疗骨质疏松性椎体压缩骨折早期疼痛缓解不佳相关因素分析[J].实用骨科杂志,2023,29(5):390-394.[13]黄洪斌,鲍丰,季向荣,等.体位复位在椎体成型术前的应用[J].中国矫形外科杂志,2008,16(14):1102-1103.[14]王冰,王蕾,杨小奇,等.过伸性体位复位结合PVP与PKP治疗骨质疏松性椎体压缩性骨折[J].临床骨科杂志,2016,19(5):522-525.[15]张黎文,王凌斌,任忠明,等.胸腰椎骨质疏松性骨折三点复位椎体后凸成形术[J].中国矫形外科杂志,2022,30(21):1930-1934.[16]肖峰,肖宏,尹泽龙,等.过伸牵引手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折的体会[J].中国骨与关节损伤杂志,2020,35(1):49-50.[17]马航展,郭伟俊,郭程辉,等.骨折复位器联合PVP与PKP治疗骨质疏松性椎体压缩性骨折疗效比较[J].实用骨科杂志,2019;25(4):353-357.[18]孙志刚,易小波,张正廉,等.体外椎体复位器联合经皮椎体成型术治疗老年椎体压缩骨折的临床疗效分析[J].现代诊断与治疗,2018,29(14):2284-2286.[19]韦竑宇,董春科,周峻,等.手法复位联合经皮椎体成形术治疗合并椎体裂隙征骨质疏松性椎体压缩骨折[J].中国骨伤,2019,32(7):591-597.[20]徐晨,吴旭才,那文婷,等.常规监护下镇静镇痛联合局部麻醉在PKP治疗多节段骨质疏松性椎体压缩骨折中的应用效果观察[J].山东医药,2023,63(33):54-57.[21]路多,代文杰,李海涛,等.经皮椎体成形术治疗OVCF术后椎体高度恢复与疼痛缓解的多因素分析[J].创伤外科杂志,2021,23(3):180-181.[22]Griffoni C,Lukassen JNM,Babbi L,et al.Percutaneousvertebroplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral fractures:a prospective randomized comparison[J].Eur Spine J,2020,29(7):1614-1620.

相似文献/References:

[1]刘小花.经皮穿刺椎体成形术治疗老年性骨质疏松性 椎体压缩骨折的疗效分析[J].医学信息,2018,31(05):186.[doi:10.3969/j.issn.1006-1959.2018.05.070]
　LIU Xiao-hua.The Effect of Percutaneous Vertebroplasty in the Treatment of Senile Osteoporotic Vertebral Compression Fracture[J].Journal of Medical Information,2018,31(09):186.[doi:10.3969/j.issn.1006-1959.2018.05.070]
[2]李海龙,刘成升,刘艺明,等.PVP与PKP经单侧入路治疗骨质疏松性椎体压缩骨折的疗效比较[J].医学信息,2021,34(04):136.[doi:10.3969/j.issn.1006-1959.2021.04.036]
　LI Hai-long,LIU Cheng-sheng,LIU Yi-ming,et al.Comparison of the Curative Effect of PVP and PKP in the Treatment of Osteoporotic Vertebral Compression Fractures via Unilateral Approach[J].Journal of Medical Information,2021,34(09):136.[doi:10.3969/j.issn.1006-1959.2021.04.036]
[3]刘长志.经皮椎体成形术对骨质疏松性椎体压缩骨折患者VAS及ODI评分的影响[J].医学信息,2019,32(22):112.[doi:10.3969/j.issn.1006-1959.2019.22.036]
　LIU Chang-zhi.Effect of Percutaneous Vertebroplasty on VAS and ODI Scores in Patients with Osteoporotic Vertebral Compression Fractures[J].Journal of Medical Information,2019,32(09):112.[doi:10.3969/j.issn.1006-1959.2019.22.036]
[4]谭兆惠.经皮椎体成形术与经皮椎体后凸成形术治疗重度骨质疏松性椎体压缩骨折的疗效[J].医学信息,2019,32(24):111.[doi:10.3969/j.issn.1006-1959.2019.24.038]
　TAN Zhao-hui.Efficacy of Percutaneous Vertebroplasty and Percutaneous Kyphoplasty for Severe Osteoporotic Vertebral Compression Fractures[J].Journal of Medical Information,2019,32(09):111.[doi:10.3969/j.issn.1006-1959.2019.24.038]
[5]王彦金,周英杰,黄 勇.单、双侧椎弓根入路经皮椎体成形术治疗骨质疏松型椎体压缩骨折的对比研究[J].医学信息,2023,36(08):127.[doi:10.3969/j.issn.1006-1959.2023.08.027]
　WANG Yan-jin,ZHOU Ying-jie,HUANG Yong,et al.Comparative Study of Unilateral and Bilateral Pedicle Approach Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures[J].Journal of Medical Information,2023,36(09):127.[doi:10.3969/j.issn.1006-1959.2023.08.027]

更新日期/Last Update: 1900-01-01