H型与O型骨水泥分布形态对PKP治疗OVCF疗效的影响及其与邻椎骨折的相关性研究  

The influence of bone cement distribution on clinical efficacy of PKP in treatment of OVCF and recurrence of adjacent vertebral fractures

作　　者：唐广满[1] 唐可[1] 张烨[1] TANG Guang-man;TANG Ke;ZHANG Ye(Department of Orthopedics,The 904th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army,Wuxi,Jiangsu,214000,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院骨科,无锡214000

出　　处：《中国骨与关节杂志》2022年第1期54-57,共4页Chinese Journal of Bone and Joint

摘　　要：目的研究骨水泥的分布形态与经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床机制与影响。方法收集2016年5月至2019年4月在我院骨科确诊为OVCF的患者305例,均采用PKP治疗,并按照骨水泥分布形态分为两组,分别为H形组(n=183)和O形组(n=122)。统计学分析与比较两组手术前后的Oswestry功能障碍指数(oswestry disability index,ODI)、疼痛视觉模拟评分(visual analogue scale,VAS)、后凸Cobb’s角与骨折情况。结果H形组和O形组在术前、术后1年的VAS评分和ODI指数组间比较差异均无统计学意义(P>0.05);术后72 h H形组的VAS评分和ODI指数均明显低于O形组(P<0.05)。H形组术后第3天、术后1年的Cobb’s角低于O形组,组间差异有统计学意义(P<0.05)。术后1年,H形组再次骨折发生率明显低于O形组,组间差异有统计学意义(P<0.05)。结论行PKP治疗的OVCF患者采用H形态分布的骨水泥,早期疗效显著,且能降低邻锥再次骨折的发生率,值得优先选择。Objective To study the influence of bone cement distribution on clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF).Methods Data of 305 patients diagnosed as OVCF were collected from May 2016 to April 2019.They were all treated with PKP and divided into two groups according to the distribution of bone cement.There were 183 cases in the H-shaped group(n=183),while 122 in the O-shaped group (n=122).Oswestry disability index (ODI),visual analogue scale (VAS),kyphotic Cobb’s angle and fracture of the two groups before and after surgery were compared.Results There were no significant differences in VAS and ODI between the two groups before and 1 year after the operation (P > 0.05);VAS and ODI 72 hours after the operation in the H-shaped group were significantly lower than that in the O-shaped group.The Cobb’s angle of the H-shaped group was lower than that of the O-shaped group on the 3rd day and 1 year after the operation,and the differences between the two groups were statistically significant (P < 0.05).One year after surgery,the incidence of re-fracture in the H-shaped group was significantly lower than that in the O-shaped group,and the differences between the two groups were statistically significant (P < 0.05).Conclusions H-shaped bone cement distribution in PKP is recommended in the treatment of OVCF,which will reduce the incidence of adjacent vertebral re-fracture.

关 键 词：脊柱骨折 骨质疏松性骨折 椎体后凸成形术 骨水泥成形术 

分 类 号：R683.2[医药卫生—骨科学]