医学影像信息系统术前规划个性化穿刺方案在经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折中的应用  

Clinical efficacy analysis of PACS preoperative planning in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures in the elderly

作　　者：陈琛 李大伟 马壮田 华堃池 李尧 高雁卿 邱淳烈 CHEN Chen;LI Da-wei;MA Zhuang-tian;HUA Kun-chi;LI Yao;GAO Yan-qing;QIU Chun-lie(Department of Orthopaedics,the Anyang City People's Hospital,Anyang 455000,Henan,China;Orthopedics of the Eighth Medical Center,General Hospital of the Chinese People's Liberation Army,Beijing 100091,China;Xinxiang Medical College,Xinxiang 453000,Henan,China)

机构地区：[1]安阳市人民医院骨科,河南安阳455000 [2]中国人民解放军总医院第八医学中心骨科,北京100091 [3]新乡医学院,河南新乡453000

出　　处：《中国骨伤》2025年第2期114-118,共5页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金(编号:81972081)。

摘　　要：目的:探讨运用医学影像信息系统(picture archiving and communication system,PACS)术前规划个性化穿刺方案在皮经椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效。方法:回顾性分析自2020年1月至2021年12月行经皮椎体成形术治疗且获得1年以上随访的69例老年骨质疏松性椎体椎压缩骨折患者,34例运用PACS软件术前规划个性化穿刺方案(观察组),男8例,女26例,年龄(73.30±7.96)岁;35例采用常规治疗(对照组),男7例,女28例,年龄(77.30±7.84)岁。观察比较两组患者手术时间、骨水泥注入量、骨水泥渗漏率、骨水泥弥散情况以及1年内再发骨折情况。术前及术后1 d、1年,测量两组患者伤椎Cobb角、行疼痛视觉模拟评分(visual analogue scale,VAS)及Oswsetry功能障碍指数(Oswsetry disability indexes,ODI)评价。结果:两组患者均顺利完成手术,未出现严重手术并发症,对照组发生2例再骨折。观察组手术时间(41.9±11.9)min,少于对照组(52.7±13.6)min,差异有统计学意义(P<0.05);两组骨水泥注入量比较差异无统计学意义(P>0.05);观察组2例出现骨水泥渗漏,少于对照组8例,差异有统计学意义(P<0.05);两组骨水泥分布指数比较差异有统计学意义(P<0.05);两组伤椎Cobb角及ODI术前及术后1 d比较差异均无统计学意义(P>0.05),但术后1年时两组比较差异均有统计学意义(P<0.05);两组腰背痛VAS评分各时间点比较差异均无统计学意义(P>0.05)。结论:运用PACS软件术前规划个性化穿刺方案,能减少手术时间、降低骨水泥渗漏率,提高骨水泥弥散且更久地维持椎体术后形态及保持患者腰背部功能状态。Objective To explore the clinical effect of personalized puncture planning before surgery using Picture Archiving and Communication System(PACS)in the treatment of osteoporotic vertebral compression fractures in the elderly.Methods A total of 69 elderly patients with osteoporotic vertebral compression fractures treated by percutaneous vertebroplasty from January 202020 to December 2021 with more than 1 year of follow-up were analyzed retrospectively.Thirty-four patients were individualized for preoperative planning with PACS software(observation group),including 8 males and 26 females,with a mean age of(73.30±7.96)years old;and 35 patients were treated with conventional treatment(control group),including 7 males and 28 females,with a mean age of(77.30±7.84)years old.The operation time,the amount of cement injection,cement leakage rate,bone watertight diffusion and refracture within 1 year between two groups were observed and compared.The Cobb's angle,low back pain visual analogue scale(VAS)and the modified Oswsetry disability indexes(ODI)before surgery and 1 day,1 year after surgery were compared between two groups.Results Both groups successfully completed the operationwithout serious surgical complications,2 refractures occurred in the control group.The operation time in the observation group was(41.9±11.9)min,which was less than that in the control group(52.7±13.6)min(P<0.05).There was no significant difference in the cement injection volume between two groups(P>0.05).Two cases of cement leakage in the observation group was less than 8 in the control group(P<0.05).The bone cement distribution index of two groups had significant difference(P<0.05).There were no significant differences between two groups in Cobb's angle of the injured vertebras and ODI before and 1 day after surgery(P>0.05),however,the comparative differences were statistically significant at 1 year after surgery(P<0.05).There was no significant difference in the VAS between two groups at each time period(P>0.05).Conclusion Using the PACS so

关 键 词：个性化穿刺 骨质疏松 椎体压缩性骨折 经皮椎体成形术 骨水泥渗漏 

分 类 号：R683.2[医药卫生—骨科学]