术前影像学规划在经皮椎体成形术中的应用  

The application of preoperative imaging planning in percutaneous vertebroplasty

作　　者：刘春磊[1] 王湘江[1] 邹华[1] 龙英[1] LIU Chun-lei;WANG Xiang-jiang;ZOU Hua;LONG Ying(Dept of Orthopaedics,the Sixth Hospital Affiliated of Guangzhou Medical University,Qingyuan,Guangdong 511500, China)

机构地区：[1]广州医科大学附属第六医院骨科,广东清远511500

出　　处：《临床骨科杂志》2021年第6期777-781,共5页Journal of Clinical Orthopaedics

基　　金：广东省清远市科技局社会发展领域科技计划立项项目(编号:2019150)。

摘　　要：目的探讨术前影像学规划在经皮椎体成形术(PVP)治疗骨质疏松性胸腰椎压缩骨折中的作用。方法根据入院时间将578例骨质疏松性胸腰椎压缩骨折患者分为常规组(2012年1月~2015年12月采用常规PVP治疗的患者,348例)与规划组(2016年1~12月采用术前影像学规划指导PVP治疗的患者,230例)。通过倾向评分匹配(PSM)的方法按1∶1的比例得到与规划组在年龄、性别、术前VAS评分相匹配的常规组,两组各145例。比较两组PSM匹配前后的手术情况、疼痛VAS评分。结果PSM匹配前两组手术情况比较:术中透视次数、手术时间规划组均少(短)于常规组,差异均有统计学意义(P<0.001);术后骨水泥渗漏比、术后1 d VAS评分规划组均低于常规组,差异均有统计学意义(P<0.05)。PSM匹配后两组手术情况比较:术中透视次数、手术时间规划组少(短)于常规组,差异均有统计学意义(P<0.001);术后骨水泥渗漏比、术后1 d天VAS评分两组比较差异均无统计学意义(P>0.05)。结论术前影像学规划指导PVP治疗骨质疏松性胸腰椎压缩骨折可以减少术中透视次数、缩短手术时间。Objective To investigate the role of preoperative imaging planning in percutaneous vertebroplasty(PVP).Methods According to the admission date,578 cases with osteoporotic thoracolumbar compression fractures were divided into the conventional group(the patients were treated with the conventional PVP from January 2012 to December 2015,348 cases)and the planning group(the patients were performed with PKP under preoperative guidance of imaging planning during January to December 2016,230 cases).The conventional group was matched with the planning group in age,gender,and preoperative VAS,which were obtained by progeny score matching(PSM)at a ratio of 1∶1,with 145 cases in each group.The surgical conditions and VAS before and after PSM matching were compared between the two groups.Results The surgery situation comparison before matching:the times of intraoperative fluoroscopy and the operation time in planning group were less(shorter)than the conventional surgery group,and the differences were statistically significant(P<0.001).The postoperative leakage ratio of bone cement,VAS at postoperative 1 d of the planning group were lower than those of the conventional group,with statistical differences(P<0.05).The surgery situation comparison after matching:the times of intraoperative fluoroscopy and the operation time in planning group were less(shorter)than the conventional surgery group,and the differences were statistically significant(P<0.001);the postoperative leakage rate of bone cement,VAS at postoperative 1 d had no differences between two groups(P>0.05).Conclusions In the treatment of the osteoporotic thoracolumbar compression fractures,preoperative imaging planning guidance can reduce the times of fluoroscopy,and shorten the operation time.

关 键 词：椎体压缩性骨折 经皮椎体成形术 骨质疏松 术前规划 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]