单侧同时交叉注射小剂量骨水泥椎体后凸成形术治疗多节段骨质疏松性压缩骨折的效果  

Effect of unilateral and simultaneous cross injection of low dose bone cement kyphoplasty for the treatment of multi-level osteoporotic compression fractures

作　　者：陈思旭 陈乃用 黄宰宇 张磊 陈凯 黄承 CHEN Sixu;CHEN Naiyong;HUANG Zaiyu;ZHANG Lei;CHEN Kai;HUANG Cheng(Department of Orthopaedics,Wenzhou Medical District,the 906th Hospital of Chinese People's Liberation Army,Zhejiang Province,Wenzhou325000,China;Department of Orthopaedics,the 906th Hospital of Chinese People's Liberation Army,Zhejiang Province,Ningbo315000,China)

机构地区：[1]联勤保障部队第九〇六医院温州医疗区骨科,浙江温州325000 [2]联勤保障部队第九〇六医院骨科,浙江宁波315000

出　　处：《中国当代医药》2023年第27期80-83,87,共5页China Modern Medicine

基　　金：浙江省温州市科研项目(Y20210444);浙江省宁波市医学重点学科建设项目(2022-G01)。

摘　　要：目的评估单侧入路同时交叉注射小剂量骨水泥行球囊扩张椎体后凸成形术(PKP)术,治疗多节段骨质疏松性椎体压缩骨折(MOVCF)的临床效果。方法回顾性选取2019年1月至2022年1月联勤保障部队第九〇六医院收治的54例MOVCF患者作为研究对象,按照操作方式不同分为观察组(28例)与对照组(26例),所有患者均采用PKP手术,观察组采用单侧入路同时交叉注射小剂量骨水泥方法,对照组采用双侧逐节注射标准剂量骨水泥方法,比较两组患者的疼痛缓解、椎体高度变化等治疗效果,以及手术时间、透视次数、出血量、骨水泥用量等手术指标。结果两组患者术后4周的视觉模拟评分法(VAS)评分均低于本组术前,差异有统计学意义(P<0.05),而两组术前、术后4周的VAS评分组间比较,差异无统计学意义(P>0.05)。两组患者的疼痛变化分布比较,差异无统计学意义(P>0.05)。两组患者术前、术后3 d、末次随访时的椎体高度组间比较,差异无统计学意义(P>0.05),两组术后3 d、末次随访的椎体高度高于本组术前,差异有统计学意义(P<0.05)。两组患者椎体术后高度恢复及末次随访高度丢失比较,差异无统计学意义(P>0.05)。观察组的手术时间短于对照组,透视次数、术中出血量、骨水泥用量少于对照组,差异有统计学意义(P<0.05)。观察组发生椎体前方骨水泥渗漏2例,对照组发生椎体前方骨水泥渗漏3例,侧方渗漏1例;术后12个月随访期间所有患者均无椎管渗漏压迫、栓塞、迟发性脊髓或神经根损伤等表现。结论单侧入路同时交叉注射小剂量骨水泥PKP术治疗MOVCF的效果确切,并能够明显缩短手术时间,减少射线暴露,改善患者手术体验,达到快速、有效、安全的手术需求。Objective To evaluate the clinical efficacy of percutaneous kyphoplasty(PKP)with cross injection of low dose bone cement through a unilateral approach in the treatment of multilevel osteoporotic vertebral compression fracture(MOVCF).Methods Fifty-four patients with MOVCF admitted to the the 906th Hospital of Chinese People's Liberation Army from January 2019 to January 2022 were retrospectively selected as the study objects and divided into observation group(28 cases)and control group(26 cases)according to different operation methods.All patients underwent PKP surgery,the observation group was simultaneously injected with a small dose of bone cement by a unilateral approach,and the control group was injected with standard dose of bone cement by a bilateral node.The therapeutic effects,such as pain relief and vertebral height change,as well as surgical indexes such as operation time,fluoroscopy times,blood loss and bone cement dosage were compared between the two groups.Results The visual analogue scale(VAS)scores in two groups 4 weeks after surgery were lower than those before surgery,the differences were statistically significant(P<0.05),but there were no statistically significant differences in VAS scores before surgery and 4 weeks after surgery between two groups(P>0.05).There was no significant difference in pain distribution between the two groups(P>0.05).There were no significant differences in vertebral height between the two groups before surgery,3 days after surgery and the last follow-up(P>0.05),but the vertebral height at 3 days after surgery and the last follow-up between the two groups were higher than those before surgery,and the differences were statistically significant(P<0.05).There were no significant differences between the two groups in height recovery after vertebral operation and height loss at the last follow-up(P>0.05).The operative time of the observation group was shorter than that of the control group,and the fluoroscopy times,intraoperative blood loss and bone cement dosage were less t

关 键 词：球囊扩张椎体后凸成形术 多节段骨质疏松性椎体压缩骨折 单侧入路同时交叉注射小剂量骨水泥 手术优化 

分 类 号：R683[医药卫生—骨科学]