关键词: 椎体后凸成形术； 骨质疏松性椎体压缩骨折； 手法复位

Abstract: Objective The study was aimed at evaluating the efficacy of manipulative reduction under over-extension traction device combined with percutaneous kyphoplasty (PKP) in the treatment of elderly patients with simple thoracolumbar osteoporotic vertebral compression fracture (OVCF).Methods 86 elderly patients with simple thoracolumbar OVCF admitted from October 2019 to November 2023 were divided into an observation group (44 cases) and a control group (42 cases) according to the treatment method. The control group received PKP treatment, while the observation group received manual reduction with an over extension traction device before PKP treatment. Pain visual analog scale (VAS) was used to assess the patient's pain status before surgery, 1 day after surgery, and 30 days after surgery. Oswestry Disability Index (ODI) was used to assess the patient's lower back pain/functional impairment. The Japanese Orthopaedic Association Treatment Score (JOA) was used to assess functional impairment in the human body, and the Cobb angle and anterior edge height of the injured vertebra were measured.Results The VAS scores of the observation group and the control group one day after the operation were (2.52±0.78) points and (2.71±0.82) points respectively, and the VAS scores 30 days after the operation were (1.97±0.64) points and (2.10±0.69) points respectively.The ODI scores of the observation group and the control group one day after the operation were (25.37±7.39) % and (27.69±7.81) %, respectively, and 30 days after the operation were (21.65±6.54) % and (23.14±6.91) %, respectively.The JOA scores of the observation group and the control group one day after the operation were (23.97±1.97) points and (23.32±2.01) points respectively, and 30 days after the operation were (24.68±1.95) points and (23.91±1.98) points respectively.ompared with those before the operation, the differences were statistically significant (P<0.05), but there was no statistically significant difference between the groups (P> 0.05).The Cobb angles of kyphosis of the injured vertebrae in the observation group and the control group were (9.41±2.23) degrees and (10.89±2.40) degrees respectively one day after the operation, and (10.03±2.19) degrees and (11.36±2.21) degrees respectively 30 days after the operation. The Angle of kyphosis in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05).The anterior height of the injured vertebrae in the observation group and the control group was (23.46±2.65)mm and (21.98±2.72)mm respectively one day after the operation, and (24.05±2.71)mm and (22.24±2.70)mm respectively 30 days after the operation. Both were higher in the observation group than in the control group, and the difference was statistically significant (P<0.05).Conclusion Manipulative reduction under over-extension traction device combined with PKP treatment has a good effect on improving the spinal function of elderly OVCF patients,reducing the kyphosis deformity of the injured vertebra,increasing the height of the anterior edge of the injured vertebra and improving the level of serum indicators in bone metabolism.

Key words: percutaneous kyphoplasty; osteoporosis vertebral compression fracture; manipulative reduction