常规椎弓根螺钉与新型可灌注椎弓根螺钉固定术联合聚甲基丙烯酸甲酯骨水泥的疗效对照评价  

The clinical effects of conventional pedicle screw and novel perfusional pedicle screw combined with polymethylmethacrylate bone cement

作　　者：孔祥瑞[1] 杨计策 刘德政[1] 张福明[1] 郭元凯[1] 史凯旋[1] 刘海峰[1] 陈贺[1] 赵志超[1] 

机构地区：[1]涿州市医院骨一科,河北涿州072750

出　　处：《现代医学》2015年第2期165-168,共4页Modern Medical Journal

摘　　要：目的:比较常规椎弓根螺钉(CPS)与新型可灌注椎弓根螺钉(NPPS)固定术联合聚甲基丙烯酸甲酯(PMMA)骨水泥治疗伴骨质疏松的腰椎疾病的疗效。方法:按照手术方式将我院收治的85例伴骨质疏松的腰椎疾病患者分为实验组40例和对照组45例,实验组患者给予NPPS+PMMA治疗,对照组患者给予CPS+PMMA治疗,比较两组患者住院时间、手术时间、术中失血量、单椎体骨水泥用量及术前、术后12个月功能障碍指数(oswestry disability index,ODI)评分、固定节段Cobb角度、椎间隙髙度、椎体变形指数、固定节段的上终板凹陷角度、固定节段上位相邻椎体的下终板凹陷角度变化情况。结果:两组患者住院时间、手术时间及术中失血量比较,差异无统计学意义(P>0.05);实验组患者单椎体骨水泥用量显著高于对照组,差异具有统计学意义(P<0.05);两组患者术后ODI评分、椎间隙髙度、椎体变形指数、下终板凹陷角度均显著下降,固定节段Cobb角度、上终板凹陷角度均显著升高,与术前比较,差异具有统计学意义(P<0.05);实验组患者术后ODI评分下降幅度显著高于对照组,差异具有统计学意义(P<0.05)。结论:两种内固定方式均能取得良好的临床效果,但NPPS+PMMA在改善患者ODI评分上更具临床优势。Objective： To compare the clinical effects of the patients with lumbar diseases-osteoporosis by conventional pedicle screw（ CPS） and novel perfusional pedicle screw（ NPPS） combined with polymethylmethacrylate（ PMMA） bone cement. Methods： 85 cases of patients with lumbar diseases-osteoporosis were divided into experiment group（ 40 cases） and control group（ 45 cases） according to the surgery way. The patients in the experiment group were treated by NPPS ＋ PMMA,the patients in the control group were treated by CPS ＋ PMMA. The hospital stays,operative time,intraoperative blood loss,single vertebral body bone cement dosage,the scores of oswestry disability index（ ODI）,fixed segment Cobb angle,intervertebral disc high degree,vertebral body deformation index,vertebral body deformation index,fixed segment on the endplate concave angle,fixed section upper adjacent vertebral endplate concave angle were compared. Results： There was no significant difference on the hospital stays,operative time,intraoperative blood loss for the two groups（ P〉0. 05）; The single vertebral body bone cement dosages of patients in the experiment group were much better than those of the control group（ P〈0. 05）; The scores of ODI,intervertebral disc high degree,vertebral body deformation index,fixed section upper adjacent vertebral endplate concave angle were lower than preoperative those（ P〈0. 05）; The fixed segment Cobb angle,fixed segment on the endplate concave angle were higher than preoperative those（ P〈0. 05）.The scores of ODI in the experiment descender were higher than those in the control group（ P〈0. 05）. Conclusion：Both of the two ways have good clinical effects,the way by NPPS ＋ PMMA has better advantage on improving the scores of ODI.

关 键 词：常规椎弓根螺钉 新型可灌注椎弓根螺钉 聚甲基丙烯酸甲酯骨水泥 骨质疏松 腰椎疾病 

分 类 号：R681.53[医药卫生—骨科学]