PKP术中注入小剂量骨水泥对绝经后骨质疏松性重度腰椎体压缩性骨折  

Low-dose bone cement injection during PKP operation for postmenopausal osteoporotic severe lumbar vertebral compression fractures

作　　者：孙雨锋[1] 韦宇霞 张文[1] SUN Yu-feng(Department of Orthopedics,Anyang People's Hospital,Anyang 455000,China)

机构地区：[1]安阳市人民医院骨科 [2]安阳职业技术学院,河南安阳455000

出　　处：《牡丹江医学院学报》2020年第6期45-48,共4页Journal of Mudanjiang Medical University

摘　　要：目的探讨经皮穿刺椎体后凸成形术(Percutaneous Kyphoplasty,PKP)术中注入小剂量骨水泥对绝经后骨质疏松性重度腰椎体压缩性骨折老年患者脊椎功能的影响。方法将我院2016年11月至2018年11月间收治的绝经后骨质疏松性重度腰椎体压缩性骨折老年患者135例,根据随机数字表法分为对照组(n=67例,PKP术中注入4~6 mL骨水泥)和观察组(n=68例,PKP术中注入2~4 mL骨水泥)。随访1年,观察两组腰背部疼痛程度、脊椎功能和手术并发症发生率。结果两组患者术后1周腰背部VAS评分(2.59±0.42)分、(2.69±0.35)分和ODI指数(25.26±4.21)%、(25.95±3.95)%均较术前降低(t1=32.100,P1=0.000;t2=32.690,P2=0.000;t3=24.574,P3=0.000;t4=24.598,P4=0.000),但组间腰背部VAS评分和ODI指数手术前后对比无差异(t1=0.326,P1=0.745;t2=1.504,P2=0.135;t3=0.042,P3=0.3967;t4=0.982,P4=0.328);两组患者术后1周末、术后1年末前缘高度、椎体中部高度较术前升高(F=36.354,P=0.000;F=32.213,P=0.000)、(F=37.021,P=0.000;F=32.534,P=0.000),观察组术后1周末前缘高度、椎体中部高度较对照组低(t1=2.200,P1=0.030;t2=3.647,P2=0.000),但术后1年末两组对比无差异(t1=0.916,P1=0.361;t2=0.709,P2=0.829);观察组术后骨水泥渗漏发生率2/68(2.94%)较对照组10/67(14.93%)低(χ^2=5.985,P=0.014);邻近椎体骨折发生率1/68(1.47%)较对照组7/67(10.45%)低(χ^2=4.879,P=0.027)。结论绝经后骨质疏松性重度腰椎体压缩性骨折老年患者PKP术中注入小剂量骨水泥,可缓解腰背部疼痛,改善近期腰椎功能,降低手术并发症发生率。Objective To investigate the effect of low-dose bone cement injection during Percutaneous Kyphoplasty(PKP)on spinal function in elderly patients with severe post-menopausal osteoporotic lumbar compression fracture.Methods 135 elderly patients with severe lumbar compression fracture of postmenopausal osteoporosis admitted to our hospital from November 2016 to November 2018 were divided into control group(n=67 patients,4~6 mL bone cement was injected intraoperatively in PKP)and observation group(n=68 patients,2~4 mL bone cement was injected intraoperatively in PKP)according to the random number table method.Follow-up for 1 year was conducted to observe the degree of lower back pain,the spinal function and the incidence of surgical complications in both groups.Results One week after surgery,the lower back VAS scores(2.59±0.42)points,(2.69±0.35)points,and ODI indexes(25.26±4.21)% and(25.95±3.95)%in both groups were decreased(t1=32.100,P1=0.000;t2=32.690,P2=0.000;t3=24.574,P3=0.000;t4=24.598,P4=0.000),but there was no difference in lumbar VAS score and ODI index between groups before and after operation(t1=0.326,P1=0.745;t2=1.504,P2=0.135;t3=0.042,P3=0.3967;t4=0.982,P4=0.328).The height of front edge and middle vertebra in both groups was higher than that before surgery at1 weekend and 1 year after surgery(F=36.354,P=0.000;F=32.213,P=0.000),(F=37.021,P=0.000;F=32.534,P=0.000).The height of front edge and middle vertebral body in the observation group was lower than that in the control group one weekend after surgery(t1=2.200,P1=0.030;t2=3.647,P2=0.000),but there was no difference between the two groups at the end of 1 year after surgery(t1=0.916,P1=0.361;t2=0.709,P2=0.829).The incidence of postoperative bone cement leakage in the observation group was 2/68(2.94%)lower than that in the control group 10/67(14.93%)(χ^2=5.985,P=0.014).The incidence of vertebral fracture in the adjacent vertebra was 1/68(1.47%),which was lower than that in the control group(7/67,10.45%)(χ^2=4.879,P=0.027).Conclusion Injecting small d

关 键 词：经皮穿刺椎体后凸成形术 小剂量骨水泥 脊椎功能 

分 类 号：R683[医药卫生—骨科学]