单侧弯角椎体成形术对胸腰椎骨质疏松性椎体压缩骨折的疗效  

Clinical efficacy of unilateral vertebral body shaping surgery for thoracolumbar osteoporotic vertebral compression fractures

作　　者：王杰伟 李阳[2] 臧鹏 Wang Jiewei;Li Yang;Zang Peng(Department of Neck-Shoulder-Waist-Leg Pain,Beijing Changping District Integrated Chinese and Western Medicine Hospital,Beijing 102208,China)

机构地区：[1]北京市昌平区中西医结合医院颈肩腰腿疼痛科,102208 [2]北京市昌平区中西医结合医院医患办,102208

出　　处：《骨科临床与研究杂志》2024年第5期302-308,共7页Journal Of Clinical Orthopedics And Research

摘　　要：目的观察在胸腰椎骨质疏松性椎体压缩骨折(OVCF)患者手术治疗中引入单侧弯角椎体成形术(PCVP)的疗效。方法2019年2月至2021年11月北京市昌平区中西医结合医院颈肩腰腿疼痛科收治的92例椎体压缩骨折住院患者,根据随机数表法将入组患者分为两组,每组纳入46例,分别行PCVP治疗(观察组)与双侧穿刺经皮椎体成形术(PVP)治疗(对照组)。两组患者基线资料差异无统计学意义。两组患者平均年龄、病程及椎体责任节段对比,差异无统计学意义(t/χ^(2)=4.521、3.156、5.214,P=0.357、0.418、0.263)。记录手术指标,评估患者不同时段(治疗前、治疗后1周,1、3、6个月)视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)及日常生活活动能力评定量表(ADL)、后凸Cobb角、椎体前缘高度改善情况,记录两组并发症。结果观察组较对照组手术用时更短,术中出血量、骨水泥注入量更少(t=21.441、17.329、11.241,均P<0.001)。治疗前两组VAS、ODI、ADL评分、后凸Cobb角、椎体前缘高度差异无统计学意义(t=0.344、1.797、0.236、0.924、0.367,P=0.732、0.078、0.814、0.358、0.714)。治疗后1周,1、3、6个月观察组ADL评分、椎体前缘高度较治疗前显著提升(tADL=12.521、21.325、26.514、29.155,PADL均<0.001;t椎体前缘高度=8.316、10.225、17.525、19.332,P椎体前缘高度=0.013、<0.001、<0.001、<0.001),VAS、ODI评分、后凸Cobb角则呈下降趋势(P<0.05);两组间比较观察组较对照组改善明显(P<0.05)。观察组并发症发生率组低于对照组(χ^(2)=4.039,P=0.045)。结论PCVP治疗胸腰椎OVCF创伤小、并发症少,有利于缓解疼痛、改善患者腰椎功能及日常生活能力。Objective To observe the effectiveness and safety of vertebroplasty(PCVP)for osteoporotic vertebral compression fractures(OVCF)in the thoracic and lumbar spine.Methods From February 2019 to November 2021,92 hospitalized patients with vertebral compression fractures admitted to the Department of Neck-Shoulder-Waist-Leg Pain at Beijing Changping District Integrated Chinese and Western Medicine Hospital.Using a random number table,the enrolled patients were divided into two groups;46 patients in each group.The average age,disease duration,and vertebral segments involved showed no statistically significant differences between the two patient groups(t/χ^(2)=4.521、3.156、5.214,P=0.357、0.418、0.263).The observation group underwent percutaneous vertebroplasty(PCVP);while the control group received bilateral percutaneous vertebral body augmentation(PVP).There were no statistically significant differences in baseline characteristics between the two groups,ensuring comparability.The surgical indicators were record;the improvement of visual analogue scale(VAS),Oswestry Dysfunction Index(ODI),and ADL,kyphotic Cobb angle,and anterior vertebral height were evaluated in patients at different time periods(before treatment,1 week,1 month,3 months,and 6 months after treatment).The complications in both groups were record.Results The surgical duration was shorter,and intraoperative blood loss and bone cement injection volume were lower in the observation group compared to the control group(t=21.441,17.329,11.241,all P<0.001).There were no statistically significant differences in pre-treatment VAS,ODI,ADL scores,posterior Cobb angle,or vertebral anterior height between the two groups(t=0.344、1.797、0.236、0.924、0.367,P=0.732、0.078、0.814、0.358、0.714).After 1 week,1 month,3 months,and 6 months of treatment,the ADL score and vertebral anterior edge height in the observation group were significantly improved compared to before treatment(tADL=12.521、21.325、26.514、29.155,all PADL<0.001;t anterior vertebral height

关 键 词：椎体成形术 骨折 压缩性 骨质疏松症 腰痛 并发症 

分 类 号：R638.4[医药卫生—外科学]