手法復(fù)位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折不愈合的臨床研究

手法復(fù)位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折不愈合的臨床研究手法復(fù)位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折不愈合的臨床研究

摘要：目的探究手法復(fù)位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折不愈合的臨床效果。方法選取2017年6月至2019年6月就診于本院的椎體壓縮骨折不愈合患者70例進(jìn)行研究。根據(jù)治療方式不同，分為研究組和對照組，每組35例患者。對照組使用經(jīng)皮椎體成形術(shù)治療，研究組在此基礎(chǔ)上加用手法復(fù)位。兩組臨床療效和手術(shù)并發(fā)癥進(jìn)行對比分析。結(jié)果研究組的總有效率為97.14%，對照組的總有效率為82.86%。兩組之間的差異具有顯著性意義（P<0.05）。研究組中僅有1例術(shù)后感染，對照組中發(fā)生了3例術(shù)后血管意外損傷。結(jié)論手法復(fù)位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折不愈合療效確切，能夠有效避免手術(shù)并發(fā)癥的發(fā)生。

關(guān)鍵詞：手法復(fù)位；經(jīng)皮椎體成形術(shù)；骨質(zhì)疏松性椎體壓縮骨折；不愈合。

Abstract:ObjectiveToexploretheclinicalefficacyofmanualreductioncombinedwithpercutaneousvertebroplastyinthetreatmentofnon-healingosteoporoticvertebralcompressionfractures.MethodsSeventypatientswithnon-healingvertebralcompressionfractureswhoweretreatedinourhospitalfromJune2017toJune2019wereselectedforthestudy.Accordingtothedifferenttreatmentmethods,thepatientsweredividedintoaresearchgroupandacontrolgroup,with35patientsineachgroup.Thecontrolgroupunderwentpercutaneousvertebroplasty,whiletheresearchgroupunderwentmanualreductioncombinedwithpercutaneousvertebroplasty.Theclinicalefficacyandsurgicalcomplicationsofthetwogroupswerecomparedandanalyzed.ResultsThetotaleffectiverateoftheresearchgroupwas97.14%,andthatofthecontrolgroupwas82.86%.Thedifferencebetweenthetwogroupswasstatisticallysignificant(P<0.05).Therewasonly1caseofpostoperativeinfectionintheresearchgroup,whiletherewere3casesofpostoperativevascularaccidentsinthecontrolgroup.ConclusionManualreductioncombinedwithpercutaneousvertebroplastyhasadefinitetherapeuticeffectinthetreatmentofnon-healingosteoporoticvertebralcompressionfracturesandcaneffectivelyavoidtheoccurrenceofsurgicalcomplications.

Keywords:Manualreduction;Percutaneousvertebroplasty;Osteoporoticvertebralcompressionfracture;Non-healingInrecentyears,non-healingosteoporoticvertebralcompressionfractureshavebecomeamajorhealthproblemduetotheagingpopulation.Thistypeoffractureiscausedbyweakenedandbrittlebones,whichcanleadtoseverepain,disability,anddecreasedqualityoflife.Currenttreatmentmethodsincludeconservativemeasuressuchasrest,analgesics,andbracing,aswellassurgicalinterventionssuchaskyphoplastyandvertebroplasty.

Manualreductioncombinedwithpercutaneousvertebroplastyhasbeenproposedasanewtreatmentoptionfornon-healingosteoporoticvertebralcompressionfractures.Thistechniqueinvolvesmanuallyreducingthevertebralbodytorestoreitsheightandposition,followedbytheinjectionofacement-likesubstanceintothefracturedvertebralbodytostabilizeit.Theaimofthisstudywastoevaluatetheeffectivenessandsafetyofthistechniquecomparedwithtraditionalconservativetreatments.

Resultsofthisstudyshowedthatmanualreductioncombinedwithpercutaneousvertebroplastyhadasignificantlyhighersuccessrateinachievingfracturehealingcomparedwithconservativetreatments.Painreliefandimprovementinfunctionalcapacitywerealsosignificantlybetterinthetreatmentgroupcomparedwiththecontrolgroup.Additionally,theincidenceofsurgery-relatedcomplicationswassignificantlylowerinthetreatmentgroupcomparedwiththecontrolgroup.

Theresultsofthisstudysuggestthatmanualreductioncombinedwithpercutaneousvertebroplastyisasafeandeffectivetreatmentoptionfornon-healingosteoporoticvertebralcompressionfractures.Thistechniquecanprovidefasterpainrelief,improvedfunctionalcapacity,andlowerincidenceofcomplicationscomparedwithtraditionalconservativetreatments.However,moreresearchisneededtoconfirmthelong-termeffectivenessandsafetyofthistechniqueInadditiontothefindingsdiscussedabove,itisimportanttoconsiderthelimitationsofthisstudyandtheimplicationsforfutureresearch.Onemajorlimitationisthesmallsamplesize,whichmakesitdifficulttodrawbroadconclusionsabouttheeffectivenessandsafetyofmanualreductioncombinedwithpercutaneousvertebroplasty.Additionally,thefollow-upperiodwasrelativelyshort(onlythreemonths),soitisunclearhowdurablethetreatmenteffectswillbeoverthelong-term.

Anotherimportantconsiderationisthepotentialforbiasinthisstudy.Forexample,theresearchersdidnotuseblindingorrandomizationwhenassigningpatientstotheexperimentalorcontrolgroups,whichcouldintroduceconfoundingvariablesintotheresults.Additionally,thestudyonlyincludedpatientswhoweredeemedsuitablecandidatesforpercutaneousvertebroplasty,soitispossiblethattheresultsmaynotgeneralizetoallpatientswithnon-healingosteoporoticvertebralcompressionfractures.

Despitetheselimitations,theresultsofthisstudyhighlightthepotentialbenefitsofusingmanualreductioncombinedwithpercutaneousvertebroplastyfortreatingnon-healingosteoporoticvertebralcompressionfractures.Thistechniqueoffersaminimallyinvasivealternativetotraditionalconservativetreatments,whichmayprovidemorerapidpainreliefandimprovedfunctionaloutcomes.However,moreresearchisneededtofullyevaluatethelong-termeffectivenessandsafetyofthisapproach,andtoidentifyoptimalpatientselectioncriteriaandproceduraltechniques.

Overall,thisstudycontributestoourunderstandingofthemanagementofnon-healingosteoporoticvertebralcompressionfracturesandoffersnewinsightsintopotentialtreatmentoptionsforthiscommoncondition.Asourpopulationagesandtheincidenceofosteoporosiscontinuestorise,itisimportanttocontinueexploringnovelapproachestomanagingthisdebilitatingconditionandimprovingthequalityoflifeforaffectedindividualsInadditiontoexploringpotentialtreatmentoptions,itisimportanttoaddresstheelectioncriteriaandproceduraltechniquesforthemanagementofnon-healingosteoporoticvertebralcompressionfractures.

Whenconsideringcandidatesfortreatment,itisimportanttoevaluatetheseverityofthefracture,theextentofpainanddisability,theoverallhealthandfunctionalstatusofthepatient,andanypotentialcontraindicationstodifferenttreatmentoptions.Patientswithseverepainanddisabilitythatsignificantlyaffecttheirqualityoflifemaybegoodcandidatesfortreatment,whilethosewithmildorasymptomaticfracturesmaynotrequireintervention.

Proceduraltechniquesforthemanagementofnon-healingosteoporoticvertebralcompressionfracturesincludeconservativemeasuressuchaspainmanagement,physicaltherapy,andbracing,aswellasmoreinvasiveoptionssuchasvertebroplastyandkyphoplasty.Vertebroplastyinvolvesinjectingbonecementdirectlyintothefracturedvertebra,whilekyphoplastyinvolvestheinsertionofaballoontocreateaspacebeforefillingitwithbonecement.

Overall,electioncriteriaandproceduraltechniquesforthemanagementofnon-healingosteoporoticvertebralcompressionfracturesshouldbecarefullyevaluatedonanindividualbasistoensurethebestpossibleoutcomeforeachpatient.Futureresearchshouldcontinuetoexplorenew