后路PSO治疗胸腰段陈旧性椎体骨质疏松性压缩性骨折的效果及安全性研究
【摘要】目的探讨后路经椎弓根次全椎体截骨术（PSO）治疗胸腰椎陈旧性椎体骨质疏松性骨折的效果及安全性。方法采用后路PSO治疗12例胸腰椎陈旧性椎体骨质疏松性骨折患者，术后定期随访，比较手术前及术后12个月时Cobb角、视觉模拟量表（VAS）、日本骨科学会（JOA）评分，并使用过屈过伸位X线片和CT扫描观察植骨融合情况。结果12例患者均顺利完成手术，无发生死亡、大血管损伤和截瘫等严重并发症。术后11例获随访，该11例在术后12个月均达骨性融合，未见假关节形成，其胸腰段局部后凸Cobb 角（12.6±2.5）度，VAS及JOA评分分别为（3.9±1.2）、（4.3±1.4）分，均比术前改善（P均<0.001）。结论后路PSO治疗胸腰段陈旧性椎体骨质疏松性骨折安全、有效、并发症少，是一种比较理想的治疗方法。
【关键词】胸腰段；骨质疏松；陈旧性骨折；椎体压缩性骨折；经椎弓根次全椎体截骨术
【Abstract】ObjectiveTo evaluate the clinical efficacy and safety of posterior pedicle subtraction osteotomy （PSO） in the treatment of old thoracolumbar osteoporotic vertebral compression fracture. MethodsTwelve patients diagnosed with old thoracolumbar osteoporotic vertebral compression fracture underwent posterior PSO. During postoperative follow-up， Cobb angle， visual analogue scale （VAS） and Japanese Orthopaedic Association （JOA） scores were evaluated before and 12 months after PSO. X-ray film and CT scan were performed to assess the status bone fusion. ResultsAll 12 patients successfully underwent PSO without severe postoperative complications， such as death， great vascular injury or paraplegia， etc. Among them， 11 patients were subject to postoperative follow-up. Bone fusion was obtained in all 11 cases at postoperative 12 months. No signs of pseudarthrosis were observed. The Cobb angle of the thoracolumbar segment was （12.6±2.5）， the VAS and JOA scores were （3.9±1.2） and （4.3±1.4） points， which were significantly improved compared with preoperative values （all P<0.0...
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