Clinical study on manual reduction combined with percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar spinal compression fractures
10.3760/cma.j.cn115455-20240507-00379
- VernacularTitle:手法复位配合经皮椎体成形术治疗骨质疏松性胸腰段脊柱压缩骨折的临床研究
- Author:
Haitao ZHOU
1
;
Pei LIU
Author Information
1. 北京市隆福医院骨科，北京 100010
- Publication Type:Journal Article
- Keywords:
Osteoporotic fractures;
Manual reduction;
Percutaneous vertebroplasty;
Thoracic and lumbar spinal compression fractures;
Vertebral height
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(3):221-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical efficacy of manual reduction combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic thoracolumbar spinal compression fractures through a prospective study.Methods:A total of 124 patients with osteoporotic thoracolumbar compression fractures admitted to Beijing Luoyang Orthopedic Hospital from January 2020 to December 2022 were prospectively selected and randomly divided into a treatment group and a control group, with 62 patients in each group. The control group underwent PVP surgery, while the treatment group underwent PVP surgery after manual reduction. Compare the treatment efficacy, surgical related indicators, pain level, vertebral height and Cobb angle between two groups.Results:The total effective rate of the treatment group was higher than that of the control group: 93.55% (58/62) vs. 80.65% (50/62), and the difference was statistically significant ( P<0.05). The intraoperative fluoroscopy time and single vertebral body surgery time in the treatment group were shorter than those in the control group: (54.87 ± 9.42) s vs. (76.32 ± 10.06) s, (29.51 ± 7.89) min vs. (38.59 ± 8.35) min, with statistical significance ( P<0.01); there was no statistically significant difference in the diffusion coefficient between the two groups of bone cement ( P>0.05). On postoperative 1, 3, and 7 d, the visual analog score (VAS) of the treatment group were lower than those of the control group: (4.43 ± 1.06) points vs. (5.31 ± 1.14) points, (3.16 ± 0.62) points vs. (4.25 ± 0.77) points, (1.28 ± 0.35) points vs. (2.14 ± 0.49) points, with statistical significance ( P<0.01). The incidence of complications in the treatment group was lower than that in the control group: 3.22% (2/62) vs. 12.90% (8/62), and the difference was statistically significant ( P<0.05). The vertebral height of the treatment group was higher than that of the control group at 3 and 6 months after surgery: (23.79 ± 2.16) mm vs. (21.34 ± 2.23) mm, (23.60 ± 2.04) mm vs. (21.22 ± 2.16) mm, and the Cobb angle of the treatment group was lower than that of the control group at 3 and 6 months after surgery: (19.24 ± 2.68)° vs. (21.76 ± 3.00)°, (14.43 ± 2.51)° vs. (17.79 ± 2.64)°, with statistical significance ( P<0.01). Conclusions:In patients with osteoporotic thoracolumbar compression fractures, manual reduction combined with PVP surgery is beneficial for shortening intraoperative fluoroscopy time and surgery time, reducing pain, restoring patient vertebral height, improving Cobb angle, restoring vertebral function, enhancing bone density, and has low treatment costs. It is worth promoting and implementing.
