三维多角度应力强化灌注PVP手术治疗老年骨质疏松椎体压缩性骨折疗效分析  

Analysis of the therapeutic Effect of three-dimensional and multi-angle stress-enhanced perfusion PVP surgery on elderly osteoporotic vertebral Compression Fractures

作　　者：赵东华 ZHAO Donghua(Department of Orthopedics,Jiaomei Coal Industry(Group)Co,Ltd.Central Hospital,Jiaozuo Henan 454000,China)

机构地区：[1]焦煤煤业(集团)有限责任公司中央医院骨科,河南焦作454000

出　　处：《临床研究》2024年第1期27-30,共4页Clinical Research

摘　　要：目的评估三维多角度应力强化灌注下经皮穿刺椎体成形术(PVP)对老年骨质疏松性椎体压缩性骨折(OVCF)的实际疗效。方法前瞻性纳入2022年3月至2023年3月于焦煤煤业(集团)有限责任公司中央医院骨科病区收治的OVCF老年患者为研究对象,共89例,所有患者均于院内行PVP手术。依据计算机随机数表法简单随机分为对照组(n=45)及试验组(n=44)。对照组给予常规PVP方式,试验组给予经椎弓根入路靶向骨折部位弥散灌注、椎骨骨折线旁应力侧强化骨水泥灌注的三维多角度灌注方式。随访6个月。比较两组治疗前后Oswestry功能指数、骨密度值、Cobb角及下肢行走能力、治疗有效率。随访结束后,统计两组治疗、随访期间(二次骨折、骨水泥泄露、腰椎持续性应激性疼痛)不良反应发生率。结果两组治疗后Oswesty功能指数、Cobb角均显著下降,骨密度T值、10m最大步行速度、平均步长均显著高于治疗前,差异有统计学意义(P<0.05)。试验组Oswesty功能指数[(39.95±8.24)分]显著低于对照组[(43.55±8.39)分],差异有统计学意义(P<0.05)。治疗后,对照组与试验组骨密度T值分别为(-1.05±0.13)、(-1.56±0.11);Cobb角分别为(11.55±2.01)°、(10.53±1.55)°;10 m最大步行速度为(0.63±0.11)m/s、(0.86±0.19)m/s;平均步长为(0.68±0.09)m、(0.79±0.10)m。治疗后,试验组治疗有效率(93.18%)显著高于对照组(77.78%),差异有统计学意义(P<0.05)。治疗后,试验组不良反应发生率[9.09%(4/44)]显著低于对照组[20.00%(9/45)],差异无统计学意义(χ^(2)=2.142,P=0.143)。结论三维多角度应力强化灌注PVP手术可显著改善骨质疏松性椎体压缩性骨折老年患者脊柱功能指标,增强下肢行走能力,可有效增加骨密度,且具备一定临床安全性。Objective To evaluate the actual therapeutic effect of percutaneous vertebroplasty(PVP)under three-dimensional and multi-angle stress-enhanced perfusion on elderly osteoporotic vertebral compression fractures(OVCF).Methods A prospective study was conducted on 89 elderly OVCF patients admitted to the orthopedic ward of the Central Hospital of Jiaomei Coal Industry(Group)Co,Ltd.from March 2022 to March 2023.All patients underwent PVP surgery in the hospital.According to the computer random number table method,the patients were randomly divided into control group(n=45)and experimental group(n=44).The control group was treated with conventional PVP,while the experimental group was treated with threedimensional multi angle perfusion method that targeted the fracture site through the pedicle and enhanced bone cement perfusion on the stress side of the vertebral fracture line.Following up for 6 months.The Oswestry functional index,bone density,Cobb angle,lower limb walking ability,and treatment effectiveness between two groups before and after treatment were compared.After the follow-up,the incidence of adverse reactions during the treatment and follow-up period(secondary fractures,bone cement leakage,and persistent stressful pain of the lumbar spine)was calculated for both groups.Results The Oswesty functional index and Cobb angle significantly decreased after treatment in both groups,and the T-value of bone density,maximum walking speed of 10 meters,and average step length were significantly higher than those before treatment,with statistical significance(P<0.05).The Oswesty functional index(39.95±8.24)in the experimental group was significantly lower than that in the control group(43.55±8.39),and the difference was statistically significant(P<0.05).After treatment,the bone density T values of the control group and the experimental group were(-1.05±0.13)and(-1.56±0.11),respectively;The Cobb angles are(11.55±2.01)°and(10.53±1.55)°,respectively;The maximum walking speed of 10 meters is(0.63±0.11)m/s and(0.86±0

关 键 词：经皮椎体成形术 压缩性骨折 骨质疏松 椎体 骨水泥 三维应力强化 老年 

分 类 号：R714.2[医药卫生—妇产科学]