单侧弯角经皮椎体成形术治疗老年骨质疏松性胸腰椎椎体骨折患者的效果  

Effect of Unilateral Angular Percutaneous Vertebroplasty in the Treatment of Elderly Patients with Osteoporotic Thoracolumbar Vertebral Fractures

作　　者：程正辉 解传信 袁知富 江乐健 张洋 CHENG Zhenghui;XIE Chuanxin;YUAN Zhifu;JIANG Lejian;ZHANG Yang(Department of No.1 Surgery,Wuning County People’s Hospital,Jiujiang 332300,China)

机构地区：[1]江西省武宁县人民医院外一科,江西九江332300

出　　处：《中国伤残医学》2024年第16期70-73,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:对比分析单侧弯角经皮椎体成形术(PVP)与传统穿刺PVP治疗老年骨质疏松性胸腰椎椎体骨折患者的临床效果。方法:回顾性分析2021年1月—2022年12月武宁县人民医院收治的80例老年骨质疏松性胸腰椎椎体骨折患者临床资料,根据手术方式的不同将其分为对照组和研究组,各40例。对照组采用传统穿刺PVP治疗,研究组采用单侧弯角PVP治疗。比较两组围手术期指标、疼痛程度、腰椎功能、生活质量、骨水泥分布情况。结果:研究组手术时间短于对照组,术中出血量、X线曝光次数均少于对照组,差异均有统计学意义(P<0.05)。术前及术后24 h、3个月,两组疼痛视觉模拟评分比较,差异均无统计学意义(P>0.05)。术前、术后3个月,两组术前、术后3个月,两组日本骨科协会评分、Oswestry功能障碍指数、生活质量综合评定问卷-74评分比较,差异均无统计学意义(P>0.05)。研究组骨水泥椎体内分布不均发生率为2.50%,低于对照组的35.00%,差异有统计学意义(P<0.05)。结论:单侧弯角PVP与传统穿刺PVP治疗老年骨质疏松性胸腰椎椎体骨折患者均可有效减轻疼痛,改善腰椎功能及生活质量,但单侧弯角穿刺PVP可进一步优化围手术期指标,使骨水泥在椎体内的分布更加均匀。Objective:To compare the clinical effects of unilateral angular percutaneous vertebroplasty(PVP)and traditional puncture PVP in the treatment of elderly patients with osteoporotic Thoracolumbar vertebral fractures.Methods:The clinical data of 80 elderly patients with osteoporotic thoracolumbar vertebral fractures admitted to Wuning County People’s Hospital from January 2021 to December 2022 were retrospectively analyzed.According to different surgical methods,they were divided into a control group and a study group,with 40 cases in each group.The control group was treated with traditional puncture PVP,and the study group was treated with unilateral angular PVP.Perioperative indexes,pain degree,lumbar function,quality of life and bone cement distribution were compared between the two groups.Results:The operation time of the study group was shorter than that of the control group,the amount of intraoperative blood loss and the number of X-ray exposure were less than that of the control group,and the differences were statistically significant(P<0.05).Before surgery and 24 h,3 months after surgery,there were no significant differences in pain Visual Analogue Scale scores between the two groups(P>0.05).Before surgery and 3 months after surgery,there were no significant differences between the two groups in Japanese Orthopaedic Association score,Oswestry Disability Index and Generic Quality of Life Inventory-74 score(P>0.05).The incidence of uneven distribution of bone cement in vertebra in the study group was 2.50%,which was lower than 35.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Both unilateral angular PVP and traditional puncture PVP can effectively reduce pain and improve lumbar function and quality of life in the treatment of elderly patients with osteoporotic thoracolumbar vertebral fractures,but unilateral angular puncture PVP can further optimize perioperative indexes and make the distribution of bone cement in the vertebral body more uniform.

关 键 词：骨质疏松性胸腰椎椎体骨折 老年 单侧弯角 经皮椎体成形术 围手术期指标 疼痛程度 腰椎功能 生活质量 

分 类 号：R68[医药卫生—骨科学]