小剂量骨水泥经皮椎体成形术治疗老年性骨质疏松症多节段跳跃性脊柱压缩性骨折的疗效分析  

Analysis of the Effect of low-dose Bone Cement percutaneous Vertebroplasty in the Treatment of senile Osteoporosis with multi-level jumping vertebral Compression Fracture

作　　者：葛海龙 程长有 GE Hailong;CHENG Changyou(Department of Orthopedics,Second Affiliated Hospital of Vocational School,Luohe Henan 4620002,China;Department of Orthopedics,Xiping County Hospital of Traditional Chinese medicine,Zhumadian Henan 463900,China)

机构地区：[1]漯河医学高等专科学校第二附属医院骨科,河南漯河462000 [2]西平县中医院骨伤科,河南驻马店463900

出　　处：《临床研究》2022年第2期17-21,共5页Clinical Research

摘　　要：目的分析小剂量骨水泥经皮椎体成形术(PVP)治疗老年性骨质疏松症多节段跳跃性脊柱压缩性骨折的临床效果。方法选择2018年1月至2021年1月间在本院行PVP治疗的90例老年性骨质疏松症多节段跳跃性脊柱压缩性骨折患者的临床资料进行回顾性分析,根据手术过程中骨水泥注入量的多少,将90例研究对象分为小剂量组(≤3 mL)和常规剂量组(>3 mL),各45例,比较两组在术后疼痛、椎体功能恢复、影像学变化和并发症方面的差异。结果小剂量组和常规剂量组术后1周疼痛评分和术后4周疼痛评分均低于本组术前评分(P<0.05);但两组在术前、术后1周和术后4周三个不同阶段疼痛评分对比无明显区别(P>0.05)。小剂量组和常规剂量组术后1周脊柱功能障碍评分和术后4周脊柱功能障碍评分均低于本组术前评分(P<0.05);但两组术前、术后1周和术后4周的脊柱功能障碍评分对比无明显差异(P>0.05)。小剂量组和常规剂量组无论是手术前还是末次随访Cobb角、椎体前缘高度和椎体中部高度对比均无明显差异(P>0.05);但两组组内相比,末次随访的Cobb角均小于手术前,椎体前缘高度和椎体中部高度均高于手术前(P<0.05)。小剂量组骨水泥渗漏事件发生率6.67%明显低于常规剂量组24.44%(P<0.05)。小剂量组并发症发生率8.89%低于常规剂量组26.67%(P<0.05)。结论小剂量骨水泥PVP治疗老年性骨质疏松症多节段跳跃性脊柱压缩性骨折患者可以达到与常规剂量相近的治疗效果,但其在减少骨水泥渗漏事件的发生、降低患者并发症发生率方面更具有优势,临床治疗安全性更高。Objective To analyze the clinical effect of low-dose percutaneous vertebroplasty(PVP)with bone cement in the treatment of multilevel skipping vertebral compression fractures in elderly osteoporosis.Methods The clinical data of 90 cases of senile osteoporosis with multilevel jump spine compression fracture treated by PVP in our hospital from January to 2021 were analyzed retrospectively,according to the amount of bone cement injected during the operation,90 cases were divided into two groups:the low-dose group(≤3 mL)and the regular-dose group(>3 mL),45 cases each,the postoperative pain,recovery of vertebral function,imaging changes and complications were compared between the two groups.Results The pain scores at 1 week and 4 weeks after operation in the low-dose group and the regular-dose group were lower than those before operation(P<0.05).However,there was no significant difference in preoperative,postoperative 1-week and postoperative 4-week pain scores between the two groups(P>0.05).The spinal dysfunction scores at 1 and 4 weeks postoperatively in the low-dose group and the routinedose group were lower than those of the groups before operation(P<0.05),but there was no significant difference between the two groups in the scores of spinal dysfunction before operation,1 week after operation and 4 weeks after operation(P>0.05).There was no significant difference in the Cobb angle,the height of anterior edge of vertebral body and the height of middle vertebral body between the low-dose group and the routine-dose group(P>0.05),but within the two groups,the Cobb angle at the last follow-up was smaller than before surgery,the height of anterior edge and middle part of vertebral body were higher than that before operation(P<0.05).The total incidence of cement leakage in low dose group was 6.67%,which was significantly lower than that in normal dose group(24.44%,P<0.05).The total complication rate of low dose group was 8.89%lower than that of routine dose group(26.67%,P<0.05).Conclusion Low-dose PVP can achieve the sa

关 键 词：小剂量骨水泥 骨质疏松症 多节段跳跃性脊柱压缩性骨折 经皮椎体成形术 疼痛 并发症 

分 类 号：R687.3[医药卫生—骨科学]