骨水泥-椎体体积比与骨质疏松椎体压缩骨折治疗效果的关系  

Relationship between bone cement-vertebral volume ratio and therapeutic effect of osteoporotic vertebral compression fractures

作　　者：马超 丁江平 王斌 牛奔 穆合塔尔•吾买尔 唐国柱 杨红涛 冯新文 Ma Chao;Ding Jiangping;Wang Bin;Niu Ben;Muhetaer•Wumaier;Tang Guozhu;Yang Hongtao;Feng Xinwen(Department of Spinal Surgery,Xinjiang Bazhou People’s Hospital,Korla 841000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆巴州人民医院脊柱外科,新疆维吾尔自治区库尔勒市841000

出　　处：《中国组织工程研究》2024年第29期4652-4656,共5页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区自然科学基金项目(2022D01A03),项目负责人:丁江平;新疆巴音郭楞蒙古自治州科学技术研究项目(202312),项目负责人:冯新文;新疆巴州人民医院青年科研基金专项项目(BY202308),项目负责人:马超。

摘　　要：背景:经皮椎体成形术因操作便捷、创伤小等优点成为治疗骨质疏松性椎体压缩骨折的主要方式,但最佳的骨水泥-椎体体积比尚无定论。目的:探讨骨水泥-椎体体积比对经皮椎体成形术治疗骨质疏松性椎体压缩骨折疗效的影响。方法:回顾性分析2019年7月至2022年7月新疆巴州人民医院收治的单节段骨质疏松性椎体压缩骨折患者的临床资料,共100例,均接受经皮椎体成形术治疗,根据骨水泥-椎体体积比分为低体积组(15%≤比值≤20%)和高体积组(20%<比值≤25%),每组50例。术前及术后3 d、1年,分析患者的目测类比评分、Oswestry功能障碍指数、椎体前缘高度、伤椎Cobb角、骨水泥分布形态及骨水泥渗漏率。结果与结论:①与术前比较,100例患者术后3 d、1年的目测类比评分、椎体前缘高度、伤椎Cobb角以及术后1年的Oswestry功能障碍指数均明显改善(P<0.05);低体积组患者术后3 d、1年的目测类比评分及术后1年的Oswestry功能障碍指数与高体积组比较差异均无显著性意义(P>0.05),术后3 d、1年的椎体前缘高度均低于高体积组(P<0.05),术后3 d、1年的伤椎Cobb角均大于高体积组(P<0.05)。②低体积组患者术后骨水泥分布形态呈H型10个,O型40个;高体积比组患者术后骨水泥分布形态呈H型36个,O型14个,组间骨水泥分布形态比较差异有显著性意义(P<0.05);高体积比组、低体积组骨水泥渗漏率分别为10%,6%。③结果表明,低、高骨水泥-椎体体积比均可改善骨质疏松性椎体压缩骨折患者术后疼痛及功能障碍,其中高骨水泥-椎体体积比可更好地恢复伤椎形态,这可能与该组骨水泥分布较多呈H形有关。BACKGROUND:Percutaneous vertebroplasty has become the main treatment method for osteoporotic vertebral compression fractures due to its advantages of convenient operation and low trauma.However,the optimal bone cement-vertebral volume ratio has not been determined.OBJECTIVE:To investigate the effect of bone cement-vertebral volume ratio on percutaneous vertebroplasty for osteoporotic vertebral compression fractures.METHODS:The clinical data of 100 patients with single-stage osteoporotic vertebral compression fractures admitted to Xinjiang Bazhou People’s Hospital from July 2019 to July 2022 were retrospectively analyzed.All patients received percutaneous vertebroplasty.According to the bone cement-vertebral volume ratio,they were divided into the low volume group(15%≤ratio≤20%)and the high volume group(20%<ratio≤25%)with 50 cases in each group.The visual analog scale score,Oswestry disability index,vertebral anterior margin height,Cobb angle of injured vertebra,bone cement distribution pattern,and bone cement leakage rate were analyzed before surgery,3 days and 1 year after surgery.RESULTS AND CONCLUSION:(1)Compared with the preoperative results,the visual analog scale scores,vertebral anterior margin height,Cobb angle of injured vertebra at 3 days and 1 year after surgery,and Oswestry disability index at 1 year after surgery were significantly improved in 100 patients(P<0.05).There were no significant differences in visual analog scale scores at 3 days and 1 year after surgery and Oswestry disability index at 1 year after surgery between the low volume group and the high volume group(P>0.05).The vertebral anterior margin height in the low volume group was lower than that in the high volume group at 3 days and 1 year after surgery(P<0.05).The Cobb angle of the injured vertebrae in the low volume group was higher than that in the high volume group at 3 days and 1 year after surgery(P<0.05).(2)There were 10 H-type and 40 O-type bone cement distributions in the low volume group.There were 36 H-type and 14 O-

关 键 词：骨水泥-椎体体积比 经皮椎体成形术 骨质疏松性椎体压缩骨折 骨水泥分布形态 疼痛 功能障碍 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R683.2