骨水泥强化椎弓钉治疗骨质疏松胸腰椎退行性病  

Pedicle screws with cement augmentation for osteoporotic thoracolumbar degenerative diseases

作　　者：李晖[1] 彭丹[1] LI Hui;PENG Dan(Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国矫形外科杂志》2020年第23期2150-2154,共5页Orthopedic Journal of China

摘　　要：[目的]评价骨水泥强化椎弓钉治疗骨质疏松胸腰椎退行性病的临床效果。[方法] 2017年6月~2019年6月,172例骨质疏松腰椎退行性病患者接受了手术治疗,其中,82例患者接受骨水泥强化椎弓根固定;90例患者接受常规椎弓根螺钉固定。比较两组患者围手术期、随访和影像资料。[结果]强化组患者的手术时间、术中出血量、术后引流量及住院时间均显著优于常规组(P<0.05)。强化组出现1例骨水泥渗漏、未出现螺钉松动,常规组出现6例螺钉松动者。两组患者末次随访VAS和ODI评分均较术前明显降低,而JOA评分显著增加(P<0.05);术前两组间VAS、ODI和JOA评分的差异无统计学意义(P>0.05),末次随访时,强化组在VAS、ODI和JOA评分均显著优于常规(P<0.05)。两组患者末次随访时冠状面Cobb角均较术前显著减少(P<0.05),末次随访时强化组冠状面Cobb角显著小于常规组(P<0.05)。[结论]骨水泥强化椎弓根螺钉可有效解决骨质疏松患者椎体固定的难题、有效减少螺钉脱落与矫形丢失。[Objective] To evaluate the clinical outcomes of pedicle screw with bone cement augmentation for osteoporotic thoracolumbar degenerative diseases. [Methods] From June 2017 to June 2019, 172 patients underwent surgical treatment for osteoporotic thoracolumbar degenerative diseases. Of them, 82 patients had surgical procedures performed with cement-augmented pedicle screw, while the remaining 90 patients were with the conventional pedicle screw. The two groups were compared regarding perioperative, follow-up and radiographic documents. [Results] The augmented group proved significantly superior to the conventional group in operation time, intraoperative bleeding, postoperative drainage volume and hospital stay(P<0.05).The augmented group had only 1 case of bone cement leakage, had no pedicle screw loosening, by contrast, the conventional group had 6 cases of screw loosening. The VAS and ODI scores significantly decreased, whereas the JOA score significantly increased at the latest follow-up in both groups compared with those before operation. The VAS, ODI and JOA scores in the augmented group were significantly superior to those in the conventional group at the latest follow-up(P<0.05), but which were not statistically different between the two groups before operation(P>0.05). In term of radiographic assessment, the Cobb’s angles on the coronal plane significantly decreased in both groups at the latest follow-up compared with those before operation(P<0.05), which was significantly less in the augmented group than the conventional group at the latest follow-up(P<0.05). [Conclusion] The pedicle screw with bone cement augmentation is an effective approach to solve problems met in pedicle screw fixation in osteoporosis, with advantages of reducing screw loosening and correction loss.

关 键 词：骨质疏松 胸腰椎退行性病 骨水泥强化 椎弓根螺钉 

分 类 号：R681.57[医药卫生—骨科学]