骨水泥预压封堵技术在骨质疏松性胸腰椎压缩骨折经皮椎体后凸成形术中应用的效果观察  

Observation of effect of bone cement preloading plugging technology in percutaneous kyphoplasty for osteoporotic thoracolumbar compression fractures

作　　者：胡孟子 张建伟 韩猛[1] 王春增 刘光旺[1] HU Mengzi;ZHANG Jianwei;HAN Meng;WANG Chunzeng;LIU Guangwang(Department of Spine Surgery,Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市中心医院骨脊柱外科,江苏221000

出　　处：《中国骨与关节损伤杂志》2024年第7期673-677,共5页Chinese Journal of Bone and Joint Injury

基　　金：徐州市科技项目(KC21206);徐州市卫生健康委员会科技项目(XWKYHT20220122);江苏省中医药科技发展计划项目(MS2022068)。

摘　　要：目的观察骨水泥预压封堵技术在老年骨质疏松性胸腰椎压缩骨折经皮椎体后凸成形术中应用的可行性和有效性。方法纳入自2022-06—2023-06采用经皮椎体后凸成形术治疗的36例(36个椎体)骨质疏松性胸腰椎压缩骨折(骨折椎体压缩塌陷高度达到原来椎体高度的1/3),其中18例术中采用骨水泥预压封堵技术(观察组),18例术中采用常规技术(对照组)。比较两组术后第1天、术后3个月疼痛VAS评分、ODI指数、伤椎椎体前缘高度、伤椎Cobb角。结果36例均获得随访,随访时间4~6个月,平均4.6个月。观察组与对照组手术时间差异无统计学意义(P>0.05)。观察组术后发现1例骨水泥渗漏,对照组发现2例骨水泥渗漏,患者均无神经损伤症状。观察组与对照组术后第1天、术后3个月疼痛VAS评分、ODI指数差异无统计学意义(P>0.05)。观察组术后第1天、术后3个月伤椎椎体前缘高度大于对照组,观察组术后第1天、术后3个月伤椎Cobb角小于对照组,差异有统计学意义(P<0.05)。结论骨水泥预压封堵技术在骨质疏松性胸腰椎压缩骨折经皮椎体后凸成形术中应用安全、有效,在明显缓解患者胸腰背部疼痛的同时,能更有效地维持椎体复位后的高度,改善脊柱后凸畸形。Objective To observe the feasibility and effectiveness of bone cement preloading plugging technology in percutaneous kyphoplasty for osteoporotic thoracolumbar compression fractures in the elderly.Methods A total of 36 patients(36 vertebral bodies)with osteoporotic thoracolumbar compression fractures(the compression collapse height of the fractured vertebral body reached one third of the original vertebral height)who were treated with percutaneous kyphoplasty from June 2022 to June 2023 were enrolled.Among them,18 cases were treated with bone cement preloading plugging technology(observation group),while another 18 cases were treated with conventional technique(control group).The VAS score,ODI index,anterior edge height of injured vertebra,and Cobb angle of injured vertebra were compared between the two groups at 1 day and 3 months after operation.Results Thirty-six cases received follow-up,from 4 to 6 months after operation,on average 4.6 months.There was no significant difference in operation time between the observation group and the control group(P>0.05).One case of bone cement leakage was found in the observation group,and 2 cases of bone cement leakage were found in the control group.All patients had no symptoms of nerve injury.There was no significant difference in VAS score and ODI index between the observation group and the control group on the first day and 3 months after operation(P>0.05).The height of the anterior edge of the injured vertebra in the observation group was higher than that in the control group at 1 day and 3 months after operation,and the Cobb angle of the injured vertebra in the observation group was lower than that in the control group at 1 day and 3 months after operation,and the differences were statistically significant(P<0.05).Conclusion The application of bone cement preloading plugging technology in percutaneous kyphoplasty for osteoporotic thoracolumbar compression fractures is safe and effective.It can significantly relieve thoracolumbar back pain,maintain the height of the ve

关 键 词：胸腰椎骨折 骨质疏松性椎体压缩骨折 经皮椎体后凸成形术 骨水泥预压封堵 

分 类 号：R687.3[医药卫生—骨科学]