骨质疏松性椎体骨折患者不同椎体成形术后相邻椎体再发骨折情况比较  

Comparison of Adjacent Vertebral Body Re-fractures after Different Vertebroplasty Procedures in Patients with Osteoporotic Vertebral Fractures

作　　者：陆浩 严飞[2] 顾勇[3] LU Hao;YAN Fei;GU Yong(Department of Orthopaedics,Zhangjiagang Fifth People's Hospital,Zhangjiagang,Jiangsu Province,215600 China;Department of Orthopaedics,Zhangjiagang Hospital,Soochow University,Zhangjiagang,Jiangsu Province,215600 China;Department of Orthopaedics,the First Hospital of Soochow University,Suzhou,Jiangsu Province,215006 China)

机构地区：[1]张家港市第五人民医院骨科,江苏张家港215600 [2]苏州大学附属张家港医院骨科,江苏张家港215600 [3]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《系统医学》2022年第20期5-8,16,共5页Systems Medicine

基　　金：第十五批“六大人才高峰”高层次人才选拔培养资助计划(WSW-018)。

摘　　要：目的探究骨质疏松性椎体骨折患者不同椎体成形术后相邻椎体再发骨折情况。方法回顾性分析2018年10月—2020年9月于张家港市第五人民医院接受治疗椎体强化手术治疗的骨质疏松性椎体骨折的86例患者的临床资料,依据手术方法不同分为经皮椎体成形术(percutaneous vertebroplasty,PVP)组(n=49)及经皮球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)组(n=37)。观察至术后1年,对比两组围术期指标、疼痛评分(VAS评分)及下腰背部功能评分(ODI评分)、后凸Cobb’s角、并发症发生情况。结果PVP组手术时间短于PKP组,差异有统计学意义(t=3.933,P<0.001);两组透视次数、骨水泥灌注量比较,差异无统计学意义(P>0.05);手术前后VAS评分、ODI指数及后凸Cobb’s角比较,差异有统计学意义(t=43.622、23.433、4.254,P<0.001);PVP组相邻椎体再发骨折率为20.41%,高于PKP组的2.70%,差异有统计学意义(χ^(2)=4.444,P=0.035)。结论PKP及PVP治疗骨质疏松性椎体骨折均可有效缓解骨折端疼痛,促使后凸Cobb’s角恢复,改善下腰背功能,但PKP手术可有效预防相邻椎体再发骨折,值得推广。Objective To investigate the recurrent fractures of adjacent vertebrae after different vertebroplasty procedures in patients with osteoporotic vertebral fractures.Methods The clinical data of 86 patients with osteoporotic vertebral fractures treated with vertebral body strengthening surgery at the Fifth People′s Hospital of Zhangjiagang City from October 2018 to September 2020 were retrospectively analyzed.The patients were divided into the percutaneous vertebroplasty(PVP)group(n=49)and the percutaneous kyphoplasty(PKP)group(n=37)according to the surgical method.The perioperative indexes,pain score(VAS score)and lower back function score(ODI score),posterior convexity Cobb′s angle,and complication rate were compared between the two groups until 1 year after surgery.Results The operative time was shorter in the PVP group than in the PKP group,and the difference was statistically significant(t=3.933,P<0.001).There was no statistically significant difference in the number of fluoroscopy and bone cement infusion volume between the two groups(P>0.05).The differences were statistically significant when comparing VAS score,ODI index and posterior convex Cobb′s angle before and after surgery(t=43.622,23.433,4.254,P<0.001).the rate of adjacent vertebral body re-fracture was 20.41%in the PVP group,which was higher than 2.70%in the PKP group,and the difference was statistically significant(χ^(2)=4.444,P=0.035).Conclusion Both PKP and PVP treatment of osteoporotic vertebral fractures can effectively relieve pain at the fracture end,induce recovery of the posterior convex Cobb′s angle,and improve lower back function,but PKP surgery can effectively prevent re-fracture of adjacent vertebrae and is worth promoting.

关 键 词：骨质疏松性椎体骨折 相邻椎体再发骨折 经皮椎体成形术 经皮球囊扩张椎体后凸成形术 疼痛 

分 类 号：R59[医药卫生—内科学]