骨质疏松性椎体压缩骨折合并椎旁肌退变患者在椎体强化术后的临床疗效分析  

Analysis of Clinical Efficacy of Percutaneous Vertebral Augmentation in Patients with Osteoporotic Vertebral Compression Fractures Combined with Paravertebral Muscle Degeneration

作　　者：苟于炜 谢贤松 陈骞[1] 文永杰 王琦琳 贾雨豪 张映波[1] Gou Yuwei;Xie Xiansong;Chen Qian;Wen Yongjie;Wang Qilin;Jia Yuhao;Zhang Yingbo(Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Upper Limb and Spine,Jiangyou People's Hospital,Mianyang 621000,China)

机构地区：[1]川北医学院附属医院骨科,南充637000 [2]江油市人民医院上肢脊柱科,绵阳621000

出　　处：《成都医学院学报》2025年第2期313-316,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椎体强化治疗专项科研项目(No:BK-JP2020001)。

摘　　要：目的 分析骨质疏松性椎体压缩骨折(OVCF)伴椎旁肌退变(PMD)患者在椎体强化术后的临床疗效。方法 选取2022年12月至2024年4月在川北医学院附属医院骨科收治的经皮椎体球囊后凸成形术(PKP)治疗的85例OVCF患者为研究对象,根据是否合并PMD将其分为PMD组(合并PMD,n=45)和NPMD组(未合并PMD,n=40)。两组均采用PKP治疗,比较两组年龄、性别、住院时间、骨密度等一般资料;比较两组手术时间、术中出血量、伤椎节段(T10~L2、L3~L5)、单侧或双侧穿刺、骨水泥注射量等术中指标。采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估两组腰背部疼痛程度和腰椎功能改善情况。结果 两组伤椎节段占比、手术时间、术中出血量、单或双侧穿刺情况比较,差异无统计学意义(P>0.05)。术前、术后3 d两组VAS、ODI评分比较,差异无统计学意义(P>0.05)。PMD组术后1、3个月ODI评分及术后3个月VAS评分均高于NPMD组(P<0.05)。结论 PMD患者经PKP治疗,可有效改善腰背疼痛和腰椎功能。PMD可作为OVCF合并PMD患者在椎体强化术后临床疗效的观察指标。Objective To analyze the clinical efficacy of percutaneous vertebral augmentation(PVA)in patients with osteoporotic vertebral compression fractures(OVCF)combined with paravertebral muscle degeneration(PMD).Methods A total of 85 patients with OVCF treated with percutaneous balloon kyphoplasty(PKP)at the Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College from December 2022 to April 2024 were selected as the study subjects.They were divided into the PMD group(n=45)and the NPMD group(n=40)based on the presence or absence of PMD.All patients underwent PKP.And their baseline data(including age,sex,length of hospital stay and bone mineral density),and intraoperative parameters[including operative duration,intraoperative blood loss,distribution of fractured vertebral levels(T10-L2 vs.L3-L5),proportion of unilateral or bilateral puncture,and volume of bone cement injection]were compared between the two groups.The degree of low back pain and improvement in lumbar function were evaluated using the Visual Analogue Scale(VAS)and the Oswestry Disability Index(ODI).Results There was no statistically significant difference in the proportion of injured vertebral segments,operative duration,intraoperative blood loss,and proportion of unilateral or bilateral puncture between the two groups(P>0.05).There was no statistically significant difference in VAS and ODI scores between the two groups before surgery and three days after surgery(P>0.05).Patients in the PMD group had higher ODI scores at 1 and 3 months postoperatively,and higher VAS scores at 3 months postoperatively,compared to patients in the NPMD group(P<0.05).Conclusion PKP treatment in PMD patients can effectively improve low back pain and lumbar function.PMD may serve as an effective indicator for evaluating the clinical efficacy of PVA in the treatment of OVCF patients with PMD.

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

分 类 号：R685[医药卫生—骨科学]