探讨经肋横突关节间隙椎体成形术治疗胸椎骨质疏松性压缩骨折的临床疗效和安全性  

Treatment of osteoporotic compression fractures of thoracic vertebrae by transcostotransverse joint space vertebroplasty

作　　者：袁中山[1] 夏良政[1] 余涛[1] 张韬 江云云 YUAN Zhong-shan;XIA Liang-zheng;YU Tao(Department of Orthopaedics,Tongling People's Hospital,Tongling Anhui 244000,China.)

机构地区：[1]铜陵市人民医院骨科,安徽铜陵244000

出　　处：《临床和实验医学杂志》2021年第18期1977-1980,共4页Journal of Clinical and Experimental Medicine

基　　金：2016年安徽省卫生和计划生育委员会科研计划项目(编号:2016QK007)。

摘　　要：目的分析胸椎骨质疏松性压缩骨折(OVCF)治疗中经肋横突关节间隙PKP术的疗效和安全性。方法回顾性选取2019年1月至2021年1月在铜陵市人民医院住院治疗的50例胸椎OVCF患者,根据治疗方法的不同分为2组,每组各25例,实验组实施经肋横突关节间隙PKP术治疗,对照组实施单侧PKP术治疗。比较两组手术指标、Cobb角、视觉模拟评分法(VAS)评分、胸椎功能优良率、骨水泥渗漏总发生率。结果实验组手术时间为(62.52±6.26)min,长于对照组[(51.26±5.04)min],实验组术中透视次数、每个椎体骨水泥注入量分别为(26.26±3.92)次、(4.95±1.26)mL,均高于对照组[(18.24±1.55)次、(2.85±0.64)mL],差异均有统计学意义(P<0.05)。实验组术后3个月Cobb角、VAS评分分别为(14.26±1.82)°、(1.52±0.16)分,均低于对照组[(17.62±2.11)°、(3.92±0.46)分],差异均有统计学意义(P<0.05)。实验组胸椎功能优良率(96.00%)高于对照组(72.00%),骨水泥渗漏总发生率(0)低于对照组(20.00%),差异均有统计学意义(P<0.05)。结论胸椎OVCF患者采纳经肋横突关节间隙PKP术治疗,可有效减轻患者疼痛感,改善胸椎功能,预防骨水泥渗漏,但存在手术时间长,透视次数多等不足。Objective To analyze the efficacy and safety of transcostotransverse joint space PKP in the treatment of thoracic osteoporotic vertebral compression fracture(OVCF).Methods Fifty thoracic OVCF patients who were hospitalized in Tongling People's Hospital from January 2019 to January 2021 were retrospectively selected,and they were divided into 2 groups according to different treatment methods,25 cases in each group.The experimental group performed transcostotransverse joint space PKP surgery for treatment,the control group was treated with unilateral PKP,and the surgical indicators,Cobb angle,visual analog scale(VAS)score,thoracic spine function excellent and good rate,and the total incidence of bone cement leakage were compared between the 2 groups.Results The operation time of the experimental group was(62.52±6.26)min,which was longer than that of the control group[(51.26±5.04)min],the number of intraoperative fluoroscopy and the amount of bone cement injected into each vertebra of the experimental group were(26.26±3.92)times and(4.95±1.26)mL,which were higher than those of the control group[(18.24±1.55)times,(2.85±0.64)mL],the differences were statistically significant(P<0.05).The Cobb angle and VAS scores of the experimental group at 3 months after surgery were(14.26±1.82)°,(1.52±0.16)points,respectively,which were lower than those of the control group[(17.62±2.11)°,(3.92±0.46)points],and the differences were statistically significant(P<0.05).The excellent and good rate of thoracic spine function in the experimental group(96.00%)was higher than that in the control group(72.00%),and the total incidence of bone cement leakage(0)was lower than that in the control group(20.00%),the differences were statistically significant(P<0.05).Conclusion The transcostotransverse joint space PKP treatment for patients with thoracic OVCF can effectively reduce pain,improve thoracic spine function,and prevent bone cement leakage.However,there are shortcomings such as long operation time and more fluoroscopy.

关 键 词：胸椎骨质疏松性压缩骨折 经肋横突关节间隙PKP术 临床疗效 安全性 

分 类 号：R687.3[医药卫生—骨科学]