骨质疏松性椎体压缩骨折合并胸腰筋膜损伤患者在椎体强化术后临床疗效分析  

Clinical Efficacy Analysis of Vertebral Augmentation Surgery in Patients with Osteoporotic Vertebral Compression Fracture and Thoracolumbar Fascial Injury

作　　者：苟于炜 谢贤松 汪劲州 文永杰 张映波[1] Gou Yuwei;Xie Xiansong;Wang Jingzhou;Wen Yongjie;Zhang Yingbo(Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院,南充637000

出　　处：《成都医学院学报》2024年第5期802-805,共4页Journal of Chengdu Medical College

基　　金：白求恩公益基金会脊柱病理性骨折锥体强化治疗专项科研基金项目(No:BK-JP2020001)。

摘　　要：目的探讨骨质疏松性椎体压缩骨折(OVCF)合并胸腰筋膜损伤(TFI)患者在椎体强化术后的临床疗效。方法选取2022年11月至2023年8月川北医学院附属医院骨科收治的81例采用经皮椎体球囊后凸成形术(PKP)治疗的OVCF患者为研究对象,根据是否合并TFI进行分组,将合并TFI的患者作为TFI组(n=36),未合并TFI患者作为NTFI组(n=45)。比较两组患者年龄、性别、住院时间、骨密度等一般资料;手术时间、术中出血量、伤椎节段(T10-L2、L3-I5)占比、单侧或双侧穿刺占比、骨水泥注射量等术中指标。分别采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估患者腰部疼痛程度和腰椎功能改善情况。结果两组患者伤椎节段占比、手术时间、术中出血量、单或双侧穿刺占比比较,差异均无统计学意义(P>0.05)。两组患者术前、术后3 d VAS、ODI评分比较,差异均无统计学意义(P>0.05)。TFI组患者术后1、3个月VAS、ODI评分均高于NTFI组患者(P<0.05)。结论TFI组患者在采用PKP治疗后3个月内,腰椎疼痛缓解程度和腰椎功能改善情况均较NTFI组患者差,TFI可作为OVCF合并TFI患者在椎体强化术后临床疗效观察的有效指标。Objective To explore the clinical efficacy of vertebral augmentation surgery in patients with osteoporotic vertebral compression fracture(OVCF)and thoracolumbar fascial injury(TFI).Methods A total of 81 patients with OVCF admitted to the Department of Orthopedics of the Affiliated Hospital of North Sichuan Medical College from November 2022 to August 2023 were selected as the research objects.The patients with TFI were assigned to the TFI group(n=36),and those without TFI were assigned to the NTFI group(n=45).Both groups were treated with percutaneous kyphoplasty(PKP).The general data(age,gender,length of hospital stay,and bone mineral density),and intraoperative indicators[duration of operation,intraoperative blood loss,proportion of affected vertebral segments(T10-L2,L3-I5),proportion of unilateral or bilateral puncture,and volume of bone cement injected]were compared between the two groups.Visual Analog Scale(VAS)score,Oswestry Disability Index(ODI)were applied to assess the relief of patients'lower back pain and functional improvement.Results There was no statistically significant difference between the two groups in the intraoperative indicators of proportion of affected vertebral segments,duration of operation,intraoperative blood loss,and proportion of unilateral or bilateral puncture(P>0.05).Preoperative and postoperative 3 d VAS and ODI scores showed no significant difference between the two groups(P>0.05).However,at 1 month and 3 months after surgery,the VAS and ODI scores in the TFI group were higher than those in the NTFI group(P<0.05).Conclusion Patients in the TFI group showed less improvement in the lower back pain and function compared to those in the NTFI group.TFI may serve as an effective indicator for evaluating the outcomes of vertebral augmentation in OVCF patients with TFI.

关 键 词：骨质疏松性椎体压缩骨折 胸腰筋膜 脊柱微创 椎体强化术 临床疗效 

分 类 号：R685[医药卫生—骨科学]