椎体后凸成形术中不同穿刺层面治疗骨质疏松性椎体骨折的效果分析  

Effect Analysis of Different Puncture Levels in the Treatment of Osteoporotic Vertebral Fracture during Percutoneous Kyphoplasty

作　　者：孙佼 陈金[1] 崔巍[1] 马春艳[1] 金耀[1] SUN Jiao;CHEN Jin;CUI Wei;MA Chunyan;JIN Yao(Department of Orthopaedics,Xiangcheng People's Hospital of Suzhou,Suzhou 215131,China;不详)

机构地区：[1]苏州市相城人民医院骨科,江苏苏州215131

出　　处：《中国医学创新》2024年第30期12-16,共5页Medical Innovation of China

摘　　要：目的:探讨椎体后凸成形术中不同穿刺层面治疗骨质疏松性椎体骨折的效果,并观察骨水泥分布情况。方法:将苏州市相城人民医院2020年3月—2022年2月收治的68例骨质疏松性椎体骨折患者随机分为同一穿刺层面组(A组,n=34)和不同穿刺层面组(B组,n=34)。比较两组手术时间、注入骨水泥量、术后下床活动时间和总住院天数;比较两组骨水泥分布情况、骨水泥渗漏、神经损伤及再发椎体骨折情况;比较两组术前和术后3 d、12个月的视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、伤椎前后缘高度比、Cobb角。结果:两组手术时间、注入骨水泥量、术后下床活动时间、总住院天数比较,差异均无统计学意义(P>0.05)。两组骨水泥渗漏、神经损伤发生率比较,差异均无统计学意义(P>0.05);B组弥散分布率较A组高,再发椎体骨折率较A组低,差异均有统计学意义(P<0.05)。两组术后3 d、12个月的VAS评分、ODI、伤椎前后缘高度比及Cobb角较术前均明显改善,B组术后12个月的VAS评分、ODI、伤椎前后缘高度比及Cobb角均优于A组,差异均有统计学意义(P<0.05)。结论:椎体后凸成形术中穿刺针位于不同穿刺层面,能获得更好的骨水泥分布和远期疗效,降低再发椎体骨折的发生。Objective:To investigate the effect of different puncture levels in the treatment of osteoporotic vertebral fracture during percutoneous kyphoplasty and observe the distribution of bone cement.Method:A total of 68 patients with osteoporotic vertebral fracture admitted to Xiangcheng People's Hospital of Suzhou from March 2020 to February 2022 were randomly divided into the same puncture level group(group A,n=34)and different puncture level group(group B,n=34).The operation time,the amount of bone cement injected,the time of getting out of bed and the total hospitalization days were compared between the two groups.The distribution of bone cement,leakage of bone cement,nerve injury and recurrent vertebral fracture were compared between the two groups.Visual analogue scale(VAS)scores,Oswestry disability index(ODI),anterior-to-posterior margin height ratio of injured vertebra and Cobb angle were compared between the two groups before and 3 days and 12 months after surgery.Result:There were no significant differences in the operation time,the amount of bone cement injected,the time of getting out of bed and the total hospitalization days between the two groups(P>0.05).There were no significant differences in the incidences of bone cement leakage and nerve injury between the two groups(P>0.05).The dispersion distribution rate of group B was higher than that of group A,and the recurrent vertebral fracture rate was lower than that of group A,the differences were statistically significant(P<0.05).Compared with those before surgery,VAS scores,ODI,anterior-to-posterior margin height ratio of injured vertebra and Cobb angle of both groups were significantly improved 3 days and 12 months after surgery,and VAS score,ODI,anterior-to-posterior margin height ratio of injured vertebra and Cobb angle of group B were better than those of group A 12 months after surgery,the differences were statistically significant(P<0.05).Conclusion:The puncture needle located at different puncture levels during percutoneous kyphoplasty can obtain b

关 键 词：骨质疏松性椎体骨折 椎体后凸成形术 穿刺层面 骨水泥分布 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]