高黏度骨水泥单侧PVP手术治疗创伤性椎体压缩性骨折患者  

Unilateral PVP with high viscosity bone cement in the treatment of traumatic vertebral compression fractures with

作　　者：刘艳明 杨鹏[1] LIU Yanming;YANG Peng(Department of Orthopaedics,Dingzhou People's Hospital,Baoding 073000,China)

机构地区：[1]定州市人民医院骨科,河北保定073000

出　　处：《中国急救复苏与灾害医学杂志》2020年第7期820-823,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2018年度河北省医学科学研究重点课题计划(编号:20181776)。

摘　　要：目的研究高黏度骨水泥单侧经皮椎体成形术(percutaneous vertebroplasty,PVP)手术治疗对创伤性椎体压缩性骨折患者伤椎平衡能力及生物力学性能的影响。方法选取2016年4月一2018年3月定州市人民医院收治的创伤性椎体压缩性骨折(vetebral compression fractures,VCF)患者,随机分为观察组(n=41)与对照组(n=41)。两组患者均进行PVP治疗,观察组给予高黏度骨水泥,对照组给予普通低黏度骨水泥。采用视觉模拟评分(visual analogue score,VAS)评分及Oswestry功能障碍指数(oswestry disbility index,ODI)评估两组患者术前、术后3d、术后3个月、术后1年疼痛情况及运动功能。观察两组患者术前、术后3d、术后3个月、术后1年伤椎椎体高度及Cobb角。观察两组术后1年内骨水泥渗漏情况及并发症发生情况。利用三维重建模型与有限元分析软件,对两组术前、术后1年生物学性能进行分析。结果术后3d、术后3个月、术后1年两组VAS评分与ODI指数均随时间推移呈降低趋势,术后各时间点VAS评分及ODI指数均低于本组术前(P<0.05);术后各时间点观察组VAS评分及ODI指数均低于对照组(P<0.05)。术后3d、术后3个月、术后1年两组伤椎高度随时间延长而增加,Cobb角随时间延长而降低,两组术后各时间点伤椎高度均高于本组术前,Cobb角均低于本组术前(P<0.05);观察组术后各时间点伤椎高度均高于对照组,Cobb角均低于对照组(P<0.05)。术后1年观察组最大位移高于对照组(P<0.05);术后1年两组应力值及最大位移值均高于本组术前(P<0.05)。结论高黏度骨水泥单侧PVP手术能提升创伤性VCF患者伤椎高度,伤椎功能恢复速度,减轻患者术后疼痛,同时促进椎体生物力学性能恢复。Objective To investigate the ffects of unilateral puneture percutaneous vertebroplasty(PVP)with high viscosity bone cement on vertebral balance and biomechanical properties in patients with traumatic vertebral compression fractures(VCF).Methods 82 patients with traumatic VCF were randomly divided into 2 equal groups undergoing unilateral PVP with bone cement,observation group with high viscosity bone cement,and control group with low viscosity bone cement.V isual Analogue Scale/Score(VAS)was used to measure the pain degree,Oswestry disability index(ODI)was used to access the vertebral movement function,and CT scanning was used to record the height and Cobb angle of the injured vertebra before and 3 days,3 months.Bone cement leakage and complications were observed in the two groups within 1 year after operation.And 1 year after the operation,CT scanning was used to observe the bone cement leakage.Biomechanical properties and maximum displacement were measured before and 1 year after the PVP.Results The VAS and 0DI values at the diferent postoperative time points in both groups were all significantly lower than those before treatment in the same group(both P<0.05),and the VAS and ODI values at different postoperative time points were all significantly lower in the observation group than in the control group(all P<0.05).The values of height of injured vertebrae 3d,3mon and 1 year after treatment were all significanly higher than those before treatment in both groups(all P<0.05),and those in the observation group were all significantly higher than in the control group(all P<0.05).The Cobb angle 3d,3mon and 1 year after the PVP were all significanly lower than before the PVP in both groups(all P<0.05).and were all significanly lower in the observation group than in the control group(all P<0.05).The maximum displacement value 1 year after PVP of the observation group was sigificantly higher than that of the control group(P<0.05).Conclusion Unilateral PVP with high viscosity bone cement for patients with traumatic VCF e

关 键 词：高黏度骨水泥 单侧PVP手术 创伤性椎体压缩性骨折 伤椎平衡 生物力学 

分 类 号：R264[医药卫生—中医外科学]