【摘要】 目的：探討球囊多点扩张经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折的综合应用效果。方法：选取2019年3月-2020年12月本院收治的80例老年胸腰椎压缩性骨折患者为研究对象，采用电脑随机分配的方式将其分为观察组和对照组，每组40例。对照组行切开复位经椎弓根螺钉内固定术，观察组行球囊多点扩张经皮椎体后凸成形术。比较两组首次下床时间、住院时间以及住院费用;比较两组治疗3个月后临床疗效;比较两组治疗前、治疗1周后及3个月后Oswestry功能障碍指数（ODI）和视觉模拟量表（VAS）评分;比较两组治疗前和治疗3个月后Cobb角和椎体前缘高度。结果：观察组首次下床时间与住院时间均短于对照组，而住院费用高于对照组（P<0.05）。观察组治疗总有效率为95.00%高于对照组的80.00%（P<0.05）。治疗1周后，两组VAS和ODI评分均低于治疗前（P<0.05）;治疗3个月后，两组VAS和ODI评分均低于治疗1周后（P<0.05）。观察组治疗1周和3个月后的VAS和ODI评分均低于对照组（P<0.05）。治疗3个月后，两组Cobb角均低于治疗前，且观察组低于对照组（P<0.05）;治疗3个月后，两组椎体前缘高度均高于治疗前，且观察组高于对照组（P<0.05）。结论：球囊多点扩张经皮椎体后凸成形术治疗胸腰椎压缩性骨折尽管费用高，但治疗效果较好，且能有效减轻患者疼痛，促进腰椎功能的恢复，综合效果优于切开复位经椎弓根螺钉内固定术。

【关键词】 胸腰椎压缩性骨折 球囊多点扩张经皮椎体后凸成形术 切开复位经椎弓根螺钉内固定术

Comprehensive Application of Balloon Multi-point Expansion Percutaneous Kyphoplasty in Patients with Thoracolumbar Compression Fractures/SUN Bin. //Medical Innovation of China， 2021， 18（34）： 0-047

[Abstract] Objective： To investigate the comprehensive effect of balloon multi-point expansion percutaneous kyphoplasty in the treatment of senile osteoporotic thoracolumbar compression fractures. Method： A total of 80 elderly patients with thoracolumbar compression fractures admitted to our hospital from March 2019 to December 2020 were selected as the research objects， and randomly assigned into observation group and control group by computer， with 40 cases in each group. The control group received open reduction and transpedicular screw internal fixation， the observation group received balloon multi-point expansion percutaneous kyphoplasty. The time to get out of bed for the first time， length of stay and hospitalization cost were compared between the two groups. The clinical efficacy was compared between the two groups after 3 months of treatment. Oswestry disability index （ODI） and visual analog scale （VAS） scores were compared between the two groups before treatment， 1 week after treatment and 3 months after treatment. Cobb angle and anterior vertebral height before treatment and 3 months after treatment were compared between the two groups. Result： The time to get out of bed for the first time and the length of hospitalization in the observation group were shorter than those in the control group， while the hospitalization cost was higher than that in the control group （P<0.05）. The total effective rate of observation group was 95.00% higher than 80.00% of control group （P<0.05）. After 1 week of treatment， VAS and ODI scores in both groups were lower than those of before treatment （P<0.05）; after 3 months of treatment， VAS and ODI scores in both groups were lower than those in 1 week of treatment （P<0.05）. VAS and ODI scores in the observation group were lower than those in the control group after 1 week and 3 months of treatment （P<0.05）. After 3 months of treatment， the Cobb angle in both groups were lower than before， and the observation group was lower than that of the control group （P<0.05）. After 3 months of treatment， the height of anterior vertebral margin in both groups were higher than those of before treatment， and the observation group was higher than that of the control group （P<0.05）. Conclusion： Although the cost of balloon multi-point expansion percutaneous kyphoplasty in the treatment of thoracolumbar compression fractures is high， it has good therapeutic effect， and can effectively reduce patients’ pain and promote the recovery of lumbar function. The comprehensive effect is better than open reduction and transpedicular screw internal fixation.

[Key words] Thoracolumbar compression fractures Balloon multi-point expansion percutaneous kyphoplasty Open reduction and transpedicular screw internal fixation

First-author’s address： Liaocheng Infectious Disease Hospital， Liaocheng 252000， China

doi：10.3969/j.issn.1674-4985.2021.34.010

胸腰椎压缩性骨折是临床上常见的骨科疾病类型之一，患者多表现为胸腰部位持续性疼痛和功能障碍，如不及时治疗将严重影响患者的生活质量[1]。……