弯角椎体成形术与单侧椎体成形术治疗老年脊柱压缩骨折疗效比较  

Comparison of effects of angular and unilateral vertebroplasty on spinal compression fractures in elderly patients

作　　者：范小波[1] 赵晨阳[1] 赵松涛[1] 安彪 刘晖 刘睿鑫 FAN Xiaobo;ZHAO Chenyang;ZHAO Songtao;AN Biao;LIU Hui;LIU Ruixin(Department of Orthopedics,Handan First Hospital,Handan 056000,Hebei Province,China)

机构地区：[1]邯郸市第一医院骨科,河北邯郸056000

出　　处：《新乡医学院学报》2024年第10期941-945,共5页Journal of Xinxiang Medical University

摘　　要：目的比较弯角椎体成形术与单侧椎体成形术治疗老年脊柱压缩骨折的疗效。方法选择2018年1月至2021年1月邯郸市第一医院骨科收治的122例老年脊柱压缩骨折患者为研究对象,按照手术方法将患者分为对照组和观察组,每组61例。对照组患者采用单侧椎体成形术,观察组患者采用弯角椎体成形术。比较2组患者手术时间、术中出血量和骨水泥注射量、骨水泥分布、骨水泥漏出情况、脊柱-骨盆参数、视觉模拟评分(VAS)、Barthel指数评分以及并发症发生情况。结果2组患者手术时间、术中出血量和骨水泥注射量比较差异无统计学意义(P>0.05)。2组患者Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级骨水泥分布占比比较差异无统计学意义(P>0.05);观察组患者Ⅰ级和Ⅱ级骨水泥分布总占比显著高于对照组(P<0.05)。观察组骨水泥漏出发生率显著低于对照组(P<0.05)。术前,2组患者矢状面平衡、胸椎后凸角、骨盆倾斜角、腰椎前凸角、骶骨倾斜角比较差异无统计学意义(P>0.05)。术后2组患者矢状面平衡、胸椎后凸角、骨盆倾斜角显著低于术前,且观察组患者矢状面平衡、胸椎后凸角、骨盆倾斜角显著低于对照组(P<0.05);2组患者腰椎前凸角、骶骨倾斜角显著高于术前,且观察组患者腰椎前凸角、骶骨倾斜角显著高于对照组(P<0.05)。术前,2组患者VAS评分、Barthel指数比较差异无统计学意义(P>0.05)。术后3个月,2组患者VAS评分显著低于术前,Barthel指数显著高于术前(P<0.05);观察组患者Barthel指数显著高于对照组(P<0.05),2组患者VAS评分比较差异无统计学意义(P>0.05)。治疗期间,观察组患者有1例发生椎管外血肿,并发症发生率为1.64%(1/61);对照组患者有2例发生椎管外血肿,1例发生切口感染,并发症发生率为4.92%(3/61)。2组患者的并发症发生率比较差异无统计学意义(χ^(2)=1.034,P=0.309)。结论与单侧椎体成形术比较,弯角椎体�Objective To compare the effects of angular and unilateral vertebroplasty on spinal compression fractures in the elderly.Methods A total of 122 elderly patients with spinal compression fractures admitted to the Department of Orthopedics,Handan First Hospital from January 2018 to January 2021 were selected as the research subjects.They were divided into a control group and an observation group according to the surgical method,with 61 patients in each group.Patients in the control group were treated with unilateral vertebroplasty,while patients in the observation group were treated with angular vertebroplasty.The operation time,intraoperative blood loss and bone cement injection volume,bone cement distribution,bone cement leakage,spinal-pelvic parameters,visual analogue score(VAS),Barthel index score,and the occurrence of complications were compared between the two groups.Results There was no statistically significant different in the operation time,intraoperative blood loss and bone cement injection volume between the two groups(P>0.05).The proportions of grade I,grade II,grade III and grade IV bone cement distribution also showed no significant difference between the two groups(P>0.05).The total proportion of grade I and grade II bone cement distribution in the observation group was significantly higher than that in the control group(P<0.05).The incidence of bone cement leakage in the observation group was significantly lower than that in the control group(P<0.05).Before operation,there was no statistically significant difference in sagittal balance,thoracic kyphosis angle,pelvic tilt angle,lumbar lordosis angle,and sacral slope angle between the two groups(P>0.05).After operation,the sagittal balance,thoracic kyphosis angle and pelvic tilt angle significantly decreased in the two groups compared to before operation,and the sagittal balance,thoracic kyphosis angle and pelvic tilt angle of patients in the observation group were significantly smaller than those in the control group(P<0.05);the lumbar lordosis angle

关 键 词：脊柱 压缩骨折 弯角椎体成形术 单侧椎体成形术 脊柱-骨盆参数 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]