Abstract：
OBJECTIVE: To explore clinical effect of manipulation reduction combined with vertebral plasty on osteoporotic compression fractures (OVCFs).
METHODS: Totally 61 patients with OVCFs treated from January 2022 to March 2024 were randomly divided into self-made spinal locator positioning with manipulation reduction group (treatment group) and traditional Kirchner positioning group (control group). There were 30 patients in treatment group, including 4 males and 26 females, aged from 61 to 87 years old with an average of (73.61±7.17) years old;body mass index (BMI) ranged from 15.24 to 28.89 kg·m-2 with an average of (23.90±3.20) kg·m-2;bone mineral density T value ranged from -4.90 to -2.50 SD with an avergae of (-3.43±0.75) SD;fracture to operation time was 6.50 (4.00, 10.25) d;10 patients were gradeⅠ, 13 patients were gradeⅡ, and 7 patients were grade Ⅲ according to Genant classification of fracture compression. There were 31 patients in control group, including 7 males and 24 females, aged from 61 to 89 years old with an average of (73.63±8.77) years old;BMI ranged from 18.43 to 27.06 kg·m-2 with an average of (23.67±2.35) kg·m-2;bone mineral density T value ranged from -4.60 to -2.50 SD with an avergae of (-3.30±0.68) SD;fracture to operation time was 6.00 (3.00, 8.00) d;11 patients were gradeⅠ, 9 patients were gradeⅡ, and 11 patients were grade Ⅲ according to Genant classification of fracture compression. The puncture times, X-ray fluoroscopy times and puncture time between two groups were observed and compared. Visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) and timed up and go test (TUGT) were observed and compared before operation, 3 d and 1 month after operation.
RESULTS: All patients were followed up for 1 to 3 months with an average of (2.10±0.80) months. Puncture times, X-ray fluorosecopy times and puncture time in treatment group were 5.00(4.00, 6.00) times, (29.53±5.89) times and 14.83(12.42, 21.20) min, respectively, while those in control group were 7.00(6.00, 8.00) times, (34.58±5.33) times, 22.19(17.33, 27.01) min, treatment group was better than those of control group (P<0.05). There were no significant differences in preoperative VAS, JOA and TUGT between two groups(P>0.05). VAS, JOA and TUGT in both groups were significantly improved after opeation(P<0.05). On the third day after operation, JOA score of treatment group was 23.00 (20.75, 25.00), which was higher than that of control group 20.00(19.00, 23.00)(P<0.05). TUGT of treatment group was 6.26(5.86, 6.57) s, which was better than that of control group 6.90(6.80, 7.14) s (P<0.05). Bone cement leakage occurred with 1 patient in treatment group and 2 patients in control group.
CONCLUSIONS: The optimal scheme of self-made spinal locators for locating descending verteboplasty combined with traditional Chinese medicine reduction manipulation for OVCF patients could reduce the number of intraoperative puncture times, shorten puncture times and reduce number of X-ray fluoroscopy times, and have advantages over the simple positioning of Kirschn\'s needle in restoring short-term lumbar function and standing and walking ability of postoperative patients.
METHODS: Totally 61 patients with OVCFs treated from January 2022 to March 2024 were randomly divided into self-made spinal locator positioning with manipulation reduction group (treatment group) and traditional Kirchner positioning group (control group). There were 30 patients in treatment group, including 4 males and 26 females, aged from 61 to 87 years old with an average of (73.61±7.17) years old;body mass index (BMI) ranged from 15.24 to 28.89 kg·m-2 with an average of (23.90±3.20) kg·m-2;bone mineral density T value ranged from -4.90 to -2.50 SD with an avergae of (-3.43±0.75) SD;fracture to operation time was 6.50 (4.00, 10.25) d;10 patients were gradeⅠ, 13 patients were gradeⅡ, and 7 patients were grade Ⅲ according to Genant classification of fracture compression. There were 31 patients in control group, including 7 males and 24 females, aged from 61 to 89 years old with an average of (73.63±8.77) years old;BMI ranged from 18.43 to 27.06 kg·m-2 with an average of (23.67±2.35) kg·m-2;bone mineral density T value ranged from -4.60 to -2.50 SD with an avergae of (-3.30±0.68) SD;fracture to operation time was 6.00 (3.00, 8.00) d;11 patients were gradeⅠ, 9 patients were gradeⅡ, and 11 patients were grade Ⅲ according to Genant classification of fracture compression. The puncture times, X-ray fluoroscopy times and puncture time between two groups were observed and compared. Visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) and timed up and go test (TUGT) were observed and compared before operation, 3 d and 1 month after operation.
RESULTS: All patients were followed up for 1 to 3 months with an average of (2.10±0.80) months. Puncture times, X-ray fluorosecopy times and puncture time in treatment group were 5.00(4.00, 6.00) times, (29.53±5.89) times and 14.83(12.42, 21.20) min, respectively, while those in control group were 7.00(6.00, 8.00) times, (34.58±5.33) times, 22.19(17.33, 27.01) min, treatment group was better than those of control group (P<0.05). There were no significant differences in preoperative VAS, JOA and TUGT between two groups(P>0.05). VAS, JOA and TUGT in both groups were significantly improved after opeation(P<0.05). On the third day after operation, JOA score of treatment group was 23.00 (20.75, 25.00), which was higher than that of control group 20.00(19.00, 23.00)(P<0.05). TUGT of treatment group was 6.26(5.86, 6.57) s, which was better than that of control group 6.90(6.80, 7.14) s (P<0.05). Bone cement leakage occurred with 1 patient in treatment group and 2 patients in control group.
CONCLUSIONS: The optimal scheme of self-made spinal locators for locating descending verteboplasty combined with traditional Chinese medicine reduction manipulation for OVCF patients could reduce the number of intraoperative puncture times, shorten puncture times and reduce number of X-ray fluoroscopy times, and have advantages over the simple positioning of Kirschn\'s needle in restoring short-term lumbar function and standing and walking ability of postoperative patients.
摘要：
目的：探讨手法复位联合椎体成形术治疗骨质疏松性压缩性骨折的临床效果。
方法：将2022年1月至2024年3月收治的61例OVCFs患者随机分为自制脊柱定位器定位手法复位组(治疗组)和传统Kirchner定位组(对照组)。治疗组30例,包括4名男性和26名女性，年龄61至87岁，平均（73.61±7.17）岁；体重指数（BMI）在15.24至28.89kg·m-2之间，平均为（23.90±3.20）kg·m-2；骨密度T值在-4.90至-2.50SD之间，平均为（-3.43±0.75）SD；骨折至手术时间为6.50（4.00，Ⅰ为10.25）13例患者为Ⅱ级，根据Genant骨折压缩分类，7例患者为Ⅲ级。对照组31例,包括7名男性和24名女性，年龄61至89岁，平均（73.63±8.77）岁；BMI范围为18.43至27.06kg·m-2，平均（23.67±2.35）kg·m-2；骨密度T值范围为-4.60至-2.50SD，平均SD为（-3.30±0.68）SD；骨折至手术时间为6.00（3.00，8.00，Ⅰ级）；9例患者为Ⅱ级，根据Genant骨折压缩分类，11例患者为Ⅲ级。穿刺次数，观察并比较两组患者的X线透视次数和穿刺时间。视觉模拟量表(VAS)术前观察并比较日本骨科协会(JOA)和定时试验(TUGT),术后3d和1个月。
结果：所有患者均获随访1～3个月，平均(2.10±0.80)个月。穿刺次数,治疗组的X线透视次数和穿刺时间分别为5.00（4.00，6.00）次，(29.53±5.89)次,14.83(12.42,21.20)min,分别,对照组为7.00（6.00，8.00）倍，(34.58±5.33)次,22.19(17.33,27.01)分钟,治疗组优于对照组(P<0.05)。术前VAS无显著差异，两组间JOA、TUGT比较(P>0.05)。VAS,两组患者术后JOA、TUGT均明显改善(P<0.05)。手术后的第三天，治疗组JOA评分为23.00(20.75,25.00),高于对照组20.00(19.00、23.00)(P<0.05)。治疗组的TUGT为6.26(5.86,6.57)s,治疗组优于对照组6.90(6.80,7.14)s(P<0.05)。治疗组1例发生骨水泥渗漏,对照组2例发生骨水泥渗漏。
结论：针对OVCF患者，采用自制脊柱定位器定位下行椎体成形术结合中药复位手法的最佳方案，可减少术中穿刺次数。缩短穿刺次数，减少X射线透视次数，与Kirschn针的简单定位相比，在恢复术后患者的短期腰椎功能和站立和行走能力方面具有优势。
方法：将2022年1月至2024年3月收治的61例OVCFs患者随机分为自制脊柱定位器定位手法复位组(治疗组)和传统Kirchner定位组(对照组)。治疗组30例,包括4名男性和26名女性，年龄61至87岁，平均（73.61±7.17）岁；体重指数（BMI）在15.24至28.89kg·m-2之间，平均为（23.90±3.20）kg·m-2；骨密度T值在-4.90至-2.50SD之间，平均为（-3.43±0.75）SD；骨折至手术时间为6.50（4.00，Ⅰ为10.25）13例患者为Ⅱ级，根据Genant骨折压缩分类，7例患者为Ⅲ级。对照组31例,包括7名男性和24名女性，年龄61至89岁，平均（73.63±8.77）岁；BMI范围为18.43至27.06kg·m-2，平均（23.67±2.35）kg·m-2；骨密度T值范围为-4.60至-2.50SD，平均SD为（-3.30±0.68）SD；骨折至手术时间为6.00（3.00，8.00，Ⅰ级）；9例患者为Ⅱ级，根据Genant骨折压缩分类，11例患者为Ⅲ级。穿刺次数，观察并比较两组患者的X线透视次数和穿刺时间。视觉模拟量表(VAS)术前观察并比较日本骨科协会(JOA)和定时试验(TUGT),术后3d和1个月。
结果：所有患者均获随访1～3个月，平均(2.10±0.80)个月。穿刺次数,治疗组的X线透视次数和穿刺时间分别为5.00（4.00，6.00）次，(29.53±5.89)次,14.83(12.42,21.20)min,分别,对照组为7.00（6.00，8.00）倍，(34.58±5.33)次,22.19(17.33,27.01)分钟,治疗组优于对照组(P<0.05)。术前VAS无显著差异，两组间JOA、TUGT比较(P>0.05)。VAS,两组患者术后JOA、TUGT均明显改善(P<0.05)。手术后的第三天，治疗组JOA评分为23.00(20.75,25.00),高于对照组20.00(19.00、23.00)(P<0.05)。治疗组的TUGT为6.26(5.86,6.57)s,治疗组优于对照组6.90(6.80,7.14)s(P<0.05)。治疗组1例发生骨水泥渗漏,对照组2例发生骨水泥渗漏。
结论：针对OVCF患者，采用自制脊柱定位器定位下行椎体成形术结合中药复位手法的最佳方案，可减少术中穿刺次数。缩短穿刺次数，减少X射线透视次数，与Kirschn针的简单定位相比，在恢复术后患者的短期腰椎功能和站立和行走能力方面具有优势。
