经皮椎体后凸成形与椎体成形治疗骨质疏松性椎体压缩骨折:骨水泥渗漏与术后疼痛、伤椎Cobb角、步态恢复的关系  

Percutaneous kyphoplasty and percutaneous vertebroplasty for osteoporotic vertebral compression fractures:relationship of bone cement leakage with postoperative pain,Cobb angle of injured vertebrae,and gait recovery

作　　者：李友文[1] 郑兴平[1] 曾建洪[1] 陈渝[1] Li Youwen;Zheng Xingping;Zeng Jianhong;Chen Yu(Department of Orthopedics,People’s Hospital of Dongxing District,Neijiang 641100,Sichuan Province,China)

机构地区：[1]内江市东兴区人民医院骨科,四川省内江市641100

出　　处：《中国组织工程研究》2022年第28期4494-4499,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:经皮椎体成形与经皮椎体后凸成形为治疗骨质疏松性椎体压缩骨折安全有效的手术选择,二者各有优缺点。目的:探讨经皮椎体后凸成形与椎体成形对骨质疏松性椎体压缩骨折患者早中期步态的影响。方法:选择2018年3月至2020年7月内江市东兴区人民医院脊柱外科收治的115例骨质疏松性椎体压缩骨折患者,采用随机数字表法分为2组,分别进行经皮椎体后凸成形骨水泥注射治疗(63例)与经皮椎体成形骨水泥注射治疗(52例),术中记录骨折椎体骨水泥用量及骨水泥渗漏情况。术前及术后12周进行X射线片检查,测量伤椎Cobb角;术前、术后6周及术后12周对两组患者进行步态测试及疼痛评估,疼痛评估采用目测类比评分。研究得到内江市东兴区人民医院研究伦理委员会的批准。结果与结论:①椎体后凸成形组的骨水泥用量多于椎体成形组(P<0.05),骨水泥渗漏率低于椎体成形组(12.7%,28.8%,P<0.05);②与术前比较,椎体后凸成形组术后12周的伤椎Cobb角降低(P<0.05),椎体成形组无明显变化(P>0.05);椎体后凸成形组术后12周的伤椎Cobb角低于椎体成形组(P<0.05);③两组术后的疼痛情况与步行运动功能均有明显改善,椎体后凸成形组术后6周的疼痛情况与步行运动功能改善优于椎体成形组(P<0.05),术后12周两组疼痛情况与步行运动功能比较差异无显著性意义(P>0.05);④术后12周时,骨水泥渗漏组术后疼痛、伤椎Cobb角及步态参数与非骨水泥渗漏组比较差异均无显著性意义(P﹥0.05);⑤结果表明,相较于经皮椎体成形,经皮椎体后凸成形可在治疗后早期恢复骨质疏松性椎体压缩骨折患者的步行运动功能,具有更好的骨折复位和镇痛效果,且较少发生骨水泥渗漏。BACKGROUND:Percutaneous vertebroplasty and percutaneous kyphoplasty are safe and effective surgical options for the treatment of osteoporotic vertebral compression fractures.Both have their advantages and disadvantages.OBJECTIVE:To explore the effect of percutaneous kyphoplasty and vertebroplasty on the early and mid-term gait of patients with osteoporotic vertebral compression fractures.METHODS:A total of 115 patients with osteoporotic vertebral compression fractures who were admitted to the Department of Spine Surgery,People’s Hospital of Dongxing District in Neijiang City from March 2018 to July 2020 were divided into two groups using a random number table.Percutaneous kyphoplasty bone cement injection treatment was conducted in 63 cases and percutaneous vertebroplasty bone cement injection treatment was performed in 52 cases.The amount of bone cement in the fractured vertebrae and the leakage of bone cement were recorded during the operation.X-ray examinations were performed before and 12 weeks after the operation.Cobb angle of the injured vertebrae was measured.The two groups of patients were tested for gait and pain assessment before,6,and 12 weeks after the operation.Visual analogue scale score was used for pain assessment.The study was approved by the Research Ethics Committee of the People’s Hospital of Dongxing District,Neijiang City.RESULTS AND CONCLUSION:(1)The amount of bone cement in the kyphoplasty group was more than that in the vertebroplasty group(P<0.05),and the leakage rate of bone cement was lower than that in the vertebroplasty group(12.7%,28.8%,P<0.05).(2)In comparison with preoperative data,the Cobb angle of the injured vertebrae in the kyphoplasty group decreased at 12 weeks(P<0.05),but there was no significant change in the vertebroplasty group(P>0.05).The Cobb angle of the injured vertebrae in the kyphoplasty group was lower than that of the vertebroplasty group(P<0.05).(3)The postoperative pain and walking movement function of the two groups were significantly improved,and the pain

关 键 词：骨水泥 经皮椎体后凸成形 经皮椎体成形 骨质疏松性 椎体压缩骨折 步态分析 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]