混合稳定方法治疗骨质疏松性椎体爆裂骨折的比较分析

V. Rerikh, V. D. Sinyavin
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引用次数: 1

摘要

目标。比较分析后路稳定联合水泥椎体成形术与脱蛋白同种异体骨成形术治疗骨质疏松性椎体单纯爆裂骨折的疗效。材料和方法。该研究是回顾性分析。形成两组患者,确定纳入和排除标准。随访期为12个月。评估Cobb法矫正后凸程度、术后残留后凸畸形程度、术后长期复发情况及经椎弓根固定时间。矢状面平衡参数和对患者病情的主观评价未被评估。可见,局部后凸复发、畸形不完全矫正和疼痛综合征加重的主要预测因素是损伤程度(T12椎体)、初始后凸畸形程度、术后不完全矫正(>10°)和密度测定的t判据值。固定时间的长短不影响后凸畸形的矫正效果和复发,但可能与骨质疏松的严重程度有关。当比较后路稳定方法联合水泥椎体成形术或骨成形术时,临床和影像学结果无统计学差异。
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Comparative analysis of hybrid stabilization methods in the treatment of burst fractures of the vertebral bodies associated with osteoporosis
Objective. To perform comparative analysis of posterior stabilization methods combined with cement vertebroplasty and osteoplasty with deproteinized bone allograft in the treatment of uncomplicated burst fractures of the vertebral bodies associated with osteoporosis.Material and Methods. The study was a retrospective analysis. Two groups of patients were formed, inclusion and exclusion criteria were determined. The follow-up period was 12 months. The magnitude of kyphosis correction according to the Cobb method, the magnitude of residual postoperative kyphotic deformity, its recurrence in the long term postoperative period, and the length of transpedicular fixationwere assessed. Sagittal balance parameters and subjective assessments of the patient’s condition were not evaluated.Results. With a statistically significant difference, it can be said that the main predictors of recurrence of local kyphosis, incomplete correction of deformity and increased pain syndrome are the level of injury (T12 vertebra), the degree of initial kyphotic deformity, incomplete achievement of its correction after surgery (>10°), and the value of T-criterion according to densitometry. The length of fixation does notaffect the loss of correction and recurrence of kyphosis, however it may correlate with the severity of osteoporosis.Conclusions. When comparing posterior stabilization methods in combination with cement vertebroplasty or osteoplasty, there was no statistical difference in clinical and radiological outcomes.
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