手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折不愈合的临床研究

手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折不愈合的临床研究手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折不愈合的临床研究

摘要：目的探究手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折不愈合的临床效果。方法选取2017年6月至2019年6月就诊于本院的椎体压缩骨折不愈合患者70例进行研究。根据治疗方式不同，分为研究组和对照组，每组35例患者。对照组使用经皮椎体成形术治疗，研究组在此基础上加用手法复位。两组临床疗效和手术并发症进行对比分析。结果研究组的总有效率为97.14%，对照组的总有效率为82.86%。两组之间的差异具有显著性意义（P<0.05）。研究组中仅有1例术后感染，对照组中发生了3例术后血管意外损伤。结论手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折不愈合疗效确切，能够有效避免手术并发症的发生。

关键词：手法复位；经皮椎体成形术；骨质疏松性椎体压缩骨折；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