三种手术治疗骨质疏松性椎体压缩骨折的疗效及骨水泥渗漏相关因素分析  

Analysis of the Effect of Three Kinds of Surgery on Osteoporotic Vertebral Compression Fractures and the Related Factors of Bone Cement Leakage

作　　者：陆建民 许家轩[2] LU Jian-min;XU Jia-xuan(Changshu No.1 People's Hospital,Changshu,Jiangsu,215500,China;First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属常熟医院,常熟市第一人民医院,江苏常熟215500 [2]苏州大学附属第一医院,江苏苏州215006

出　　处：《中国血液流变学杂志》2022年第4期578-582,共5页Chinese Journal of Hemorheology

摘　　要：目的探究三种手术治疗骨质疏松性椎体压缩骨折的疗效及骨水泥渗漏相关因素分析。方法病例选取2020年1月—2022年1月行单侧经皮椎体成形术(percutaneous vertebro plasty,PVP)、双侧PVP手术和行经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗的骨质疏松性椎体压缩骨折患者各33例分别为单侧组、双侧组和PKP组。对比三组患者的手术切口长度、骨水泥用量、手术时间、术后下地时间,并记录三组患者术前以及术后3、6个月的VAS评分、ODI评分、椎体前缘高度丢失率和矢状位后凸Cobb角变化,以及三组患者出现并发症的情况。结果三组患者手术切口长度和术后下地时间比较差异无统计学意义(P>0.05),骨水泥用量比较,单侧组和PKP组的骨水泥用量少于双侧组(P<0.05),但单侧组和PKP组骨水泥用量比较差异无统计学意义(P>0.05),单侧组手术时间短于双侧组和PKP组(P<0.05),但双侧组和PKP组手术时间比较差异无统计学意义(P>0.05)。三组患者VAS评分、ODI评分、椎体前缘高度丢失率和矢状位后凸Cobb角的术前比较均差异无统计学意义(P>0.05),术后3、6个月的三组患者的VAS评分、ODI评分、椎体前缘高度丢失率和矢状位后凸Cobb角与术前比较均有较明显的下降(P<0.05);但是术后3、6个月的三组患者组内VAS评分和椎体前缘高度丢失率比较差异无统计学意义(P>0.05),ODI评分和矢状位后凸Cobb角比较差异有统计学意义(P<0.05);术后3、6个月三组患者的VAS评分比较差异无统计学意义(P>0.05),但PKP组术后3、6个月的ODI评分、椎体前缘高度丢失率和矢状位后凸Cobb角均小于单侧组和双侧组(P<0.05),单侧组和双侧组间比较差异无统计学意义(P>0.05)。PKP组的并发症发生率尤其是骨水泥渗漏的发生率显著低于单侧组和双侧组(P<0.05)。结论对于骨质疏松性椎体压缩骨折患者无论是采用单、双侧PVP手术还是PKP手术治疗均能取�Objective To explore the curative effect of three kinds of surgical treatment for osteoporotic vertebral compression fractures and analyze related factors of bone cement leakage.Methods From January 2020 to January 2022,33 patients with osteoporotic vertebral compression fractures treated with unilateral percutaneous vertebroplasty(PVP),bilateral PVP and percutaneous kyphoplasty(PKP)were selected as the unilateral group,bilateral group and PKP group respectively.The length of surgical incision,the amount of bone cement,the time of operation,and the time of landing after operation were compared among the three groups of patients.The VAS score,ODI score,the loss rate of vertebral anterior edge height,and the Cobb angle change of sagittal kyphosis of the three groups of patients before and 3 and 6 months after operation were recorded,and the complications of the three groups of patients were recorded.Results There was no significant difference in the length of surgical incision and the time of landing after surgery among the three groups(P>0.05).Compared with the amount of bone cement,the amount of bone cement used in unilateral group and PKP group was less than that in bilateral group(P<0.05),but there was no difference between unilateral group and PKP group(P>0.05).The operation time in unilateral group was shorter than that in bilateral group and PKP group(P<0.05),but there was no difference between bilateral group and PKP group(P>0.05).There was no significant difference in VAS score,ODI score,loss rate of anterior vertebral height and sagittal kyphosis Cobb angle among the three groups before surgery(P>0.05),but the VAS score,ODI score,loss rate of anterior vertebral height and sagittal kyphosis Cobb angle among the three groups 3 and 6 months after surgery were significantly lower than those before surgery(P<0.05).However,there was no difference in VAS score and loss rate of anterior vertebral height among the three groups 3 and 6 months after operation(P>0.05),and there was a difference in ODI score and Cobb

关 键 词：骨质疏松性椎体压缩骨折 经皮椎体成形术 经皮椎体后凸成形术 骨水泥渗漏 腰椎功能 并发症 

分 类 号：R683.2[医药卫生—骨科学]