骨质疏松性椎骨骨折个性化穿刺经皮后凸成形  

Personalized puncture in percutaneous kyphoplasty for osteoporotic vertebral fractures

作　　者：苏保辉[1] 袁延胜 栾素娴[1] 李曰众 孙良智[1] 刘伟强[1] 于明东[1] 夏晓燕[1] SU Bao-hui;YUAN Yan-sheng;LUAN Su-xian;LI Yue-zhong;SUN Liang-zhi;LIU Wei-qiang;YU Ming-dong;XIA Xiao-yan(Department of Spinal Surgery,Peo-ple's Hospital of Weifang City,Weifang 261041,China;Department of Orthopedics,People's Hospital of Weifang Binhai Economic and Technological Development Zone,Weifang 262737,China)

机构地区：[1]潍坊市人民医院脊柱矫形外科,山东潍坊261041 [2]潍坊滨海经济技术开发区人民医院骨科,山东潍坊262737

出　　处：《中国矫形外科杂志》2023年第24期2282-2285,共4页Orthopedic Journal of China

基　　金：潍坊市卫生健康委科研项目计划项目(编号:wfwsjk_2019_002)。

摘　　要：[目的]评价骨质疏松性椎骨骨折个性化穿刺经皮后凸成形的应用价值。[方法] 2020年1月—2023年1月,骨质疏松性椎骨骨折患者共162例276椎,实施个性化穿刺经皮后凸成形术。采用VAS评分和ODI评分,以及测量影像伤椎椎体高度及局部后凸Cobb角评价临床疗效。[结果]所有患者均顺利手术,无严重并发症。23例在术中发生骨水泥渗漏,其中椎旁渗漏6例,椎间隙渗漏17例,无椎管内渗漏,均无明显临床症状。与术前相比,术后1 d和末次随访时VAS评分[(8.6±0.8),(1.8±0.7),(1.7±0.9),P<0.001]和ODI评分[(72.6±1.2),(28.4±2.3),(27.9±2.5),P<0.001],以及椎体前缘高度[(15.4±1.3) mm,(19.3±2.5) mm,(18.9±2.9) mm,P<0.001]、椎体中部高度[(17.2±1.4) mm,(21.3±3.1) mm,(20.8±3.4) mm,P<0.001]和局部后凸Cobb角[(14.6±4.3)°,(9.4±3.8)°,(9.2±4.1)°,P<0.001]均显著改善。[结论]个体化穿刺PKP治疗骨质疏松性椎骨骨折是安全、有效的治疗方法。[Objective] To evaluate the application value of personalized puncture in percutaneous kyphoplasty(PKP) for osteoporotic vertebral fractures.[Methods] From January 2020 to January 2023,162 patients with osteoporotic vertebral fractures of 276 vertebrae were treated with personalized percutaneous kyphoplasty.The clinical effect was evaluated by VAS score and ODI scores,as well as the vertebral height and local kyphotic Cobb Angle were measured on images.[Results] All patients were successfully operated on without serious complications.Although bone cement leakage occurred in 23 cases during the operation,including paravertebral leakage in 6 cases,intervertebral leakage in 17 cases and no intraspinal leakage,no obvious clinical symptoms were presented in anyone of them.Compared with those preoperatively,the VAS scores [(8.6±0.8),(1.8±0.7),(1.7±0.9),P<0.001] and ODI scores [(72.6±1.2),(28.4±2.3),(27.9±2.5),P<0.001],as well as anterior vertebral height [(15.4±1.3) mm,(19.3±2.5) mm,(18.9±2.9) mm,P<0.001],middle vertebral body height [(17.2±1.4) mm,(21.3±3.1) mm,(20.8±3.4) mm,P<0.001] and local kyphotic Cobb angle [(14.6±4.3)°,(9.4±3.8)°,(9.2±4.1)°,P<0.001] significantly improved 1 day postoperatively and at the latest follow-up.[Conclusion] This individualized puncture in PKP is a safe and effective method for the treatment of osteoporotic vertebral fractures.

关 键 词：骨质疏松性椎骨骨折 经皮后凸成形 个性化穿刺 

分 类 号：R683.2[医药卫生—骨科学]