骨水泥分布模式对骨质疏松性椎体压缩骨折术后临床治疗效果  

Clinical effects of bone cement distribution pattern following osteoporotic vertebral compression fracture

作　　者：王雪峰[1] 刘辉[1] 丁少成[1] WANG Xue-feng;LIU Hui;DING Shao-cheng(Department of Orthopedics,the second People's Hospital of Lu'an City,Lu'an,Anhui,237000,China)

机构地区：[1]六安市第二人民医院骨科

出　　处：《中国骨与关节杂志》2019年第11期836-841,共6页Chinese Journal of Bone and Joint

基　　金：安徽省教育厅自然科学重点项目(编号KJ2019A1258)

摘　　要：目的回顾性分析经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)术后骨水泥分布模式与临床治疗效果之间的关系。方法回顾性分析我院在2016年5月至2019年5月期间就诊的113例骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者。根据术后腰椎X线正位片将骨水泥分布模式分为三组。比较三组患者一般资料;术前及术后伤椎前高比,伤椎前高比恢复率,术前及术后Cobb’s角,Cobb’s角矫正角度,骨水泥体积,骨水泥渗漏;术前、术后1周(活动时,休息时)、术后1个月(活动时,休息时)的腰部疼痛程度;术前、术后1周、1个月的腰背部功能。结果组Ⅲ患者年龄(64.67±8.47)岁高于组Ⅰ患者(67.24±9.14)岁及组Ⅱ患者(72.67±9.68)岁(P<0.05)。组Ⅱ患者(0.13±0.11)及组Ⅲ患者(0.11±0.11)伤椎前高比恢复比高于组Ⅰ患者(0.05±0.08)(P<0.05)。组Ⅲ患者Cobb’s矫正角度(3.55±3.24)°均高于组Ⅰ患者(2.32±2.42)°及组Ⅱ患者(1.82±2.47)°(P均<0.05)。组Ⅲ患者骨水泥体积(7.86±2.24)ml均高于组Ⅰ患者(4.45±1.37)ml及组Ⅱ患者(5.52±2.12)ml(P<0.05)。组Ⅲ患者骨水泥渗漏例数均高于组Ⅰ及组Ⅱ患者(P<0.05)。组Ⅲ患者(3.30±1.35,2.18±1.08)及组Ⅱ患者(3.45±1.85,2.15±1.04)术后1周(活动时,休息时)VAS评分均低于组Ⅰ患者(4.51±1.68,3.21±1.15)(P<0.05)。结论PKP术后骨水泥分布越广泛,术后伤椎前高比恢复率、Cobb’s矫正角度改善更为满意并且可以早期缓解腰背部疼痛。但是,骨水泥分布越广可能增加骨水泥量及骨水泥渗漏风险。Objective To retrospectively analyze the relationship between bone cement distribution and clinical outcomes after percutaneous kyphoplasty(PKP).Methods Clinical data of 113 patients with osteoporotic vertebral compression fractures(OVCFs)were retrospectively analyzed from May 2016 to May 2019.Bone cement distribution was divided into three groups according to the AP X-ray films of the postoperative lumbar spine.General data of the three groups were compared:ratio of anterior vertebral height preoperatively and postoperatively and its recovery,Cobb’s angle preoperatively and postoperatively,correction angle of Cobb’s angle,volume of bone cement,leakage of bone cement;lumbar pain(during activity,at rest)and functions preoperatively,1 week postoperatively,1 month postoperatively.Results The mean age of groupⅢ(64.67±8.47)was higher than that of the groupⅠ(67.24±9.14)and groupⅡ(72.67±9.68)(P<0.05).The ratios of anterior vertebral height to recovery of groupⅡ(0.13±0.11)and groupⅢ(0.11±0.11)were higher than that of groupⅠ(0.05±0.08)(P<0.05).The Cobb’s correction angle of groupⅢ(3.55±3.24)was higher than that of groupⅠ(2.32±2.42)°and groupⅡ(1.82±2.47)°(P<0.05).The volume of bone cement in groupⅢ(7.86±2.24)ml was higher than that of groupⅠ(4.45±1.37)ml and groupⅡ(5.52±2.12)ml(P<0.05).The number of cement leakage in groupⅢwas higher than that of groupⅠand groupⅡ(14 vs.5,0,P<0.05).The VAS scores(during activity,at rest)of groupⅢ(3.30±1.35,2.18±1.08)and groupⅡ(3.45±1.85,2.15±1.04)were lower than those of groupⅠ(4.51±1.68,3.21±1.15)1 week after operation(P<0.05).Conclusions The wider distribution of bone cement after PKP,the better anterior vertebral height recovery and Cobb’s correction angle to alleviate lumbar and back pain.However,the risk of cement leakage may increase.

关 键 词：椎体后凸成形术 脊柱骨折 骨折 压缩性 骨质疏松性骨折 

分 类 号：R683.2[医药卫生—骨科学]