弯角经皮椎体成形术治疗新鲜单节段骨质疏松性椎体压缩骨折的临床研究  

Clinical study on percutaneous curved vertebroplasty in treatment of fresh single-segment osteoporotic vertebral compression fracture

作　　者：李悦[1] 刘新民[1] 王卫粮[1] 胡辰甫 刘长松[1] LI Yue;LIU Xin-min;WANG Wei-liang;HU Chen-fu;LIU Chang-song(Department of Orthopedics,People’s Hospital of Daxing District in Beijing,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院骨科,北京102600

出　　处：《局解手术学杂志》2021年第2期118-122,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：北京市科技计划项目(Z141100002114047)。

摘　　要：目的比较弯角与常规单侧经皮椎体成形术在新鲜单节段骨质疏松性椎体压缩骨折(OVCF)中的应用价值。方法纳入我院收治的新鲜单节段OVCF患者124例,根据手术方式分为弯角组(n=65)和单侧组(n=59),弯角组行弯角经皮椎体成形术,单侧组行单侧经皮椎体成形术。比较2组围术期指标,包括手术时间、透视次数、术中出血量、手术费用、总治疗费用。分别在术前及术后3个月、6个月采用视觉模拟量表(VAS)以及Oswestry功能障碍指数(ODI)评估2组疼痛、功能恢复情况,并比较2组椎体压缩率、Cobb角、骨密度。观察2组骨水泥分布情况,记录2组术后6个月内骨水泥渗漏、再发骨折、伤口感染、伤口延迟愈合发生率。结果弯角组手术时间长于单侧组,透视次数少于单侧组(P<0.05),但2组术中出血量、手术费用及总治疗费用比较,差异无统计学意义(P>0.05)。2组术后3个月、6个月的ODI、VAS评分均较术前降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。2组术后3个月、6个月的椎体压缩率较术前降低,Cobb角较术前变小,骨密度较术前增大,且弯角组术后3个月、6个月的椎体压缩率较单侧组低,Cobb角较单侧组小(P<0.05)。弯角组骨水泥分布合理率高于单侧组(P<0.05),骨水泥渗漏率低于单侧组(P<0.05);2组再发骨折、伤口感染、伤口延迟愈合发生率比较,差异无统计学意义(P>0.05)。结论与单侧经皮椎体成形术相比,弯角经皮椎体成形术能减少透视次数,降低骨水泥渗漏率,改善术后椎体压缩率、Cobb角及骨水泥分布情况。Objective To compare the application value of percutaneous curved vertebroplasty and unilateral percutaneous vertebroplasty in fresh single-segment osteoporotic vertebral compression fracture(OVCF).Methods A total of 124 patients with fresh single-segment OVCF admitted to our hospital were included and divided into the curved group(n=65)and the unilateral group(n=59)according to the surgical method.The curved group underwent percutaneous curved vertebroplasty,and the unilateral group underwent the unilateral percutaneous vertebroplasty.The perioperative indicators between the two groups were compared,including operation time,number of fluoroscopy,intraoperative blood loss,surgical cost,and total treatment cost.The visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate the pain and functional recovery of the two groups before operation and 3 months,6 months after operation respectively,and the vertebral compression rate,Cobb angle and bone density were compared between the two groups.The bone cement distribution in the two groups was observed,and the incidence of bone cement leakage,recurrence of fracture,wound infection and delayed wound healing between the two groups within 6 months after operation were recorded.Results The operation time of the curved group was longer than that of the unilateral group,and the number of fluoroscopy was less than that of the unilateral group(P<0.05),but there was no statistically significant difference in intraoperative blood loss,surgical cost,and total treatment cost between the two groups(P>0.05).The VAS scores and ODI of the two groups 3 months,6 months after operation were lower than those before operation(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).The vertebral compression rates of the two groups 3 months,6 months after operation were lower than those before operation,and the Cobb angles were smaller than those before operation,and the bone densities were increased than those before operation(P<0.0

关 键 词：单节段骨质疏松性椎体压缩骨折 弯角经皮椎体成形术 单侧经皮椎体成形术 COBB角 骨水泥渗漏 

分 类 号：R683.2[医药卫生—骨科学]