改良“蛋壳”技术治疗老年OVCF及对脊柱矢状面平衡参数、预后的影响  

Effect of modified eggshell technique on OVCF in senile patients and spinal sagittal balance parameters and prognosis

作　　者：黄韬 杨晓华 薛天森 肖睿[2] Huang Tao;Yang Xiaohua;Xue Tiansen;Xiao Rui(Department of Orthopedics,The Second People'sHospital of Jiangyou City 621700,China;Department of Orthopedics,The First People's Hospital of Yibin,644000,China)

机构地区：[1]江油市第二人民医院骨外科,621700 [2]宜宾市第一人民医院骨外科,644000

出　　处：《中华老年骨科与康复电子杂志》2024年第6期340-348,共9页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：2016年四川省卫生和计划生育委员会科研课题(16PJ586)。

摘　　要：目的探究改良“蛋壳”技术对老年骨质疏松椎体压缩性骨折(OVCF)患者脊柱矢状面平衡参数、预后的影响。方法选取2021年5月至2022年5月本院收治的101例老年OVCF患者为研究对象,随机分为对照组50例、研究组51例。对照组予以常规经皮椎体后凸成形术(PKP)治疗,研究组予以改良“蛋壳”技术的PKP治疗。比较两组手术情况、术后康复进程、不良事件发生率、骨水泥分布情况。对比分析两组术前、术后脊柱矢状面平衡参数[腰椎前凸角(LL)、骶骨倾斜角(SS)、胸椎后凸角(TK)]、骨折愈合相关指标[骨钙素N端中分子片段(N-MID)、骨形态发生蛋白7(BMP-7)]水平、腰椎功能(ODI评分)、腰椎稳定性指标(伤椎前缘百分比、伤椎Cobb角)。结果所有患者均获得随访,随访时间6个月,男33例,女68例,平均年龄(72.71±3.74)岁。研究组骨水泥注入量[(8.21±0.83)ml]多于对照组的(6.35±0.64)ml,不良事件发生率3.92%低于对照组的18.00%,下床活动时间、住院时间分别为(2.39±0.75)h、(6.74±1.14)d,均短于对照组的(3.16±0.98)h、(7.38±1.26)d,差异有统计学意义(P<0.05);研究组骨水泥分布优良率88.24%,高于对照组的72.00%,差异有统计学意义(P<0.05);术后1个月研究组LL、SS、伤椎前缘百分比分别为(50.43±2.26)°、(28.16±3.14)°、(94.18±3.05)%,高于对照组的(48.67±2.50)°、(26.73±2.81)°、(90.26±4.47)%,差异有统计学意义(P<0.05);术后3个月研究组LL、SS、伤椎前缘百分比分别为(50.14±2.39)°、(27.88±2.95)°、(93.56±3.41)%,高于对照组(48.26±2.44)°、(26.45±2.67)°、(89.75±4.29)%,差异有统计学意义(P<0.05);术后6个月研究组LL、SS、伤椎前缘百分比分别为(49.98±2.51)°、(27.71±2.86)°、(93.18±3.77)%,高于对照组(47.81±2.39)°、(25.92±2.72)°、(89.34±4.18)%,差异有统计学意义(P<0.05);术后1个月研究组TK、ODI评分、伤椎Cobb角分别为(33.21±2.62)°、(17.29±2.23)分、(7.26±0.72)°,低于对Objective To explore the effects of modified"eggshell"technique on spinal sagittal balance parameters and prognosis in senile patients with osteoporotic vertebral compression fracture(OVCF).Methods A total of 101 elderly patients with OVCF admitted to our hospital from May 2021 to May 2022 were selected as research objects,and randomly divided into control group(50 cases)and study group(51 cases).The control group was treated with conventional percutaneous kyphoplasty(PKP),and the study group was treated with modified"eggshell"technique PKP.Operation,postoperative rehabilitation,incidence of adverse events and distribution of bone cement were compared between the two groups.Preoperative and postoperative spinal sagittal balance parameters[lumbar lordosis Angle(LL),sacral inclination Angle(SS),thoracic kyphosis Angle(TK)],fracture healing related indexes[osteocalcin n-terminal molecular fragments(N-MID),bone morphogenetic protein 7(BMP-7)],lumbar function(ODI score),and lumbar stability indexes(injured vertebra)were compared between the two groups Percentage of leading edge,Cobb Angle of injured vertebra).Results All patients were followed up for 6 months.There were 33 males and 68 females in each group,with an average age of 72.71±3.74 years.The study group had a higher cement injection volume of(8.21±0.83)ml than the control group's(6.35±0.64)ml,and the incidence of adverse events was 3.92%,which was lower than the control group's 18.00%,the time to get out of bed and hospitalization time were(2.39±0.75)hours and(6.74±1.14)days,respectively,which were shorter than the control group's(3.16±0.98)hours and(7.38±1.26)days,and the difference were statistically significant(P<0.05);the excellent and good rate of bone cement distribution in the study group was 88.24%,which was higher than the control group's 72.00%,and the difference was statistically significant(P<0.05);one month after surgery,the LL,SS,and the percentage of the anterior edge of the injured vertebra in the study group were(50.43±2.26)°,(28.16�

关 键 词：骨质疏松椎体压缩性骨折 老年 改良“蛋壳”技术 经皮椎体后凸成形术 脊柱矢状面平衡 

分 类 号：R687.3[医药卫生—骨科学]