骨质疏松性椎体压缩骨折椎体成形修复效果与骨水泥注入量及弥散程度的关系  

Correlation of percutaneous vertebroplasty effect on osteoporotic vertebral compression fracture with injection amount and dispersion degree of bone cement

作　　者：吴海波[1] 禹志军 白曼莫 Wu Haibo;Yu Zhijun;Bai Manmo(Traditional Chinese Medicine Department of Orthopedics and Traumatology,Sanya Hospital of Traditional Chinese Medicine,Sanya 572000,Hainan Province,China)

机构地区：[1]三亚市中医院中医骨伤科

出　　处：《中国组织工程研究》2020年第16期2473-2477,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家卫生部医药卫生科技研究项目(W2013ZT181)，项目参与者：吴海波、白曼莫;三亚市医疗卫生科技创新项目(2016YW06)，项目参与者：吴海波、白曼莫~~

摘　　要：背景:研究显示,椎体成形治疗中骨水泥注入量和弥散程度对骨质疏松性椎体压缩骨折患者术后恢复有一定影响,但关于椎体成形治疗中骨水泥注入量和弥散程度与椎体恢复相关性的研究报道较少。目的:探讨骨质疏松性椎体压缩骨折椎体成形后效果与骨水泥注入量及弥散程度的关系。方法:纳入2017年1月至2018年8月三亚市中医院收治的102例(109个椎体)骨质疏松性椎体压缩骨折患者,其中男42例,女60例,年龄52-76岁,均进行椎体成形骨水泥注射治疗。根据骨水泥注入量分为观察1组(注入量>4 mL,n=57)和对照1组(注入量≤4 mL,n=45),根据骨水泥弥散程度分为观察2组(填充率>15%,n=61)和对照2组(填充率≤15%,n=41),观察手术前后的目测类比评分、Oswestry功能障碍指数评分、椎体前缘高度、Cobb角变化与骨水泥渗漏发生情况,并分析骨水泥注入量、弥散程度与椎体恢复高度相关性。试验经三亚市中医院伦理委员会批准。结果与结论:①观察1组、对照1组术后3d的目测类比评分、Oswestry功能障碍指数评分均较术前明显改善(P <0.05),并且观察1组的改善情况优于对照1组(P <0.05);观察2组、对照2组术后3 d的目测类比评分、Oswestry功能障碍指数评分均较术前明显改善(P <0.05),并且观察2组的改善情况优于对照组2组(P <0.05);②观察1组、对照1组术后3d的椎体前缘高度与Cobb角均较术前明显改善(P<0.05),并且观察1组的改善情况优于对照1组(P<0.05);观察2组、对照2组术后3d的椎体前缘高度与Cobb角均较术前明显改善(P <0.05),并且观察2组的改善情况优于对照组2组(P <0.05);③观察1组、对照1组骨水泥渗漏率比较差异无显著性意义(P> 0.05),观察2组、对照2组骨水泥渗漏率比较差异无显著性意义(P> 0.05);④椎体恢复高度与骨水泥注入量、弥散程度均呈正相关性(P<0.05);⑤结果表明,适当增加骨水泥注入量和弥散程度可�BACKGROUND: Previous studies show that the amount and diffusion degree of bone cement in vertebroplasty have some influence on the postoperative recovery of patients with osteoporotic vertebral compression fracture, but there are few reports about the corr elation between the amount and diffusion degree of bone cement in vertebroplasty and the recovery of vertebral body. OBJECTIVE: To investigate the relationships between the effect of percutaneous vertebroplasty on osteoporotic vertebral compression fractures and the injection amount and dispersion degree of bone cement. METHODS: Totally 102 osteoporotic vertebral compression fracture patients(109 vertebrae) who received treatment in the Sanya Hospital of Traditional Chinese Medicine from January 2017 to August 2018, including 42 males and 60 females at the age of 52-76 years, were retrospectively analyzed. All patients received percutaneous vertebroplasty. According to the injection amount of bone cement, they were divided into two groups: observation group 1(injection > 4 mL, n=57) and control group 1(injection ≤ 4 mL, n=45). According to the degree of dispersion of bone cement, they were divided into two groups: observation group 2(filling rate > 15%, n=61) and control group 2(filling rate ≤ 15%, n=41). Visual analogue scale score, Oswestry disability index, anterior vertebral height, Cobb angle, and the occurrence of cement leakage were observed before and after surgery. The correlations of the injection amount and dispersion degree of bone cement with the height of vertebral body recovered were analyzed. This study was approved by the Medical Ethics Committee of Sanya Hospital of Traditional Chinese Medicine. RESULTS AND CONCLUSION:(1) The visual analogue scale score and Oswestry dysfunction index of patients in the observation group 1 and control group 1 at 3 days after operation were decreased compared with before operation(P < 0.05), while those in the observation group 1 were lower than those in the control group 1(P < 0.05). The visual analogue sca

关 键 词：骨水泥 骨质疏松性椎体压缩骨折 椎体成形 骨水泥注入量 弥散程度 相关性 椎体恢复高度 COBB角 

分 类 号：R459.9[医药卫生—治疗学] R683.2[医药卫生—临床医学]