新型充气脊柱支架治疗胸腰椎压缩性骨折△

A novel inflatable spine support for treatment of thoracolumbar compression fractures

摘要:

[目的] 探究新型充气脊柱支架治疗胸腰椎压缩性骨折 (thoracolumbar compression fractures, TLCF) 的疗效。[方法] 2018 年 1 月—2019 年 12 月在本院非手术治疗的 50 例 TLCF 患者纳入本研究。依据医患沟通结果，26 例采用新型脊柱充气支架治疗(支架组)；另外 24 例采用传统垫枕治疗(垫枕组)。比较两组临床与影像资料。[结果]支架组下床时间显著早于垫枕组 [(60.8±4.1)d vs (63.9±3.3)d, P=0.012]。随时间推移，两组患者的 VAS 评分和 ODI 评分均显著下降(P＜0.05)。治疗 1 周后支架组 VAS 评分 [(3.5±0.7) vs (4.1±0.8), P=0.008] 和 ODI 评分 [(29.5±2.6) vs (32.1±2.2), P＜0.001] 均明显低于垫枕组。影像方面， 随时间推移，两组腰椎前凸角和椎体前缘高度比显著增加(P＜0.05)，而局部后凸角显著下降(P＜0.05)。治疗 3 个月后支架组腰椎前凸角 [(47.3±1.0)° vs (45.3±0.9)°, P＜0.001]、局部后凸 Cobb 角 [(10.5±0.7)° vs (12.0±0.4)°, P＜0.001] 及椎体前缘高度比 [(93.1± 1.9)% vs (88.1±2.4)%, P＜0.001] 均显著优于垫枕组。[结论] 与传统垫枕治疗相比，新型充气脊柱支架可更有效维持骨折复位， 改善治疗的舒适度，改进治疗效果。

Abstract:

[Objective] To evaluate the clinical efficacy of a novel inflatable spine support (ISS) for treatment of thoracolumbar com- pression fractures (TLCF). [Methods] A total of 50 patients who received non-operative treatment for TLCF in our hospital were enrolled in- to this study from January 2018 to December 2019. Based on doctor-patient communication, 26 patients received ISS therapy, while the re- maining 24 patients underwent the conventional pad therapy. Clinical and imaging data were compared between the two groups. [Results] The ISS group resumed ambulation significantly earlier than the conventional group [(60.8±4.1)days vs (63.9±3.3)days, P=0.012]. The VAS and ODI scores decreased significantly over time in both groups (P＜0.05). The ISS group was marked significantly lower VAS score [(3.5± 0.7) vs (4.1±0.8), P=0.008] and ODI scores [(29.5±2.6) vs (32.1±2.2), P＜0.001] than the conventional group. Radiographically, lumbar lordo- sis and anterior vertebral height ratio increased significantly (P＜0.05), while the local kyphotic angle decreased significantly over time in both groups (P＜0.05). The ISS group proved significantly superior to the conventional group in terms of lumbar lordosis [(47.3±1.0)° vs (45.3±0.9)°, P＜0.001], local kyphotic angle [(10.5±0.7)° vs (12.0±0.4)°, P＜0.001] and anterior vertebral height ratio [(93.1±1.9)% vs (88.1± 2.4)%, P＜0.001] 3 weeks after treatment. [Conclusion] The new inflatable spine support does maintain fracture reduction more effectively, improve the comfort of treatment and improve the therapeutic outcomes over the conventional pad therapy.