椎体成形术中骨水泥弥散分布类型与术后治疗效果的影响研究  

Effect of Bone Cement Dispersion Pattern during Kyphoplasty on Postoperative Analgesic Efficacy

作　　者：白明[1] 王宇晗[2] 李树文[1] 吴一民[1] 张杨 张海斌 张丽天[1] BAI Ming;WANG Yuhan;LI Shuwen;WU Yimin;ZHANG Yang;ZHANG Haibin;ZHANG Litian(Second Afiliated Hospital of Inner Mongolia Medical University,Hohhot 010030 China;First Hospital of Hohhot,Honhot 010010 China)

机构地区：[1]内蒙古医科大学第二附属医院,呼和浩特010030 [2]呼和浩特市第一医院,呼和浩特010010

出　　处：《内蒙古医学杂志》2025年第1期32-35,共4页Inner Mongolia Medical Journal

基　　金：内蒙古医科大学面上项目(编号:YKD2022MS024)。

摘　　要：目的探讨应用椎体成形术治疗骨质疏松性椎体压缩性骨折(OVCF)中,骨水泥在伤椎内不同弥散分布对术后止痛效果及再骨折风险的影响。方法选择2019年10月至2021年12月内蒙古医科大学第二附属医院收治的单节段骨质疏松性椎体压缩性骨折患者202例,年龄58~82岁,平均68.2岁;腰椎骨折组112例,胸椎骨折组90例,均进行经皮椎体成形术,根据术后患者影像学资料,按骨水泥在伤椎内弥散分布以及左右对称情况分为均匀弥散对称组(A组)和偏心弥散不对称组(B组)。统计比较两组手术前后的疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)以及邻近椎体再骨折率。结果全部患者得到1年以上随访。治疗前,两组VAS评分比较差异无统计学意义(P>0.05);术后3d以及术后第3个月、第6个月,两组患者的VAS评分均有显著降低,且与治疗前比较,差异有统计学意义(P<0.05);其中术后第3日以及术后第3个月,A组VAS评分与B组VAS评分比较,差异有统计学意义(P<0.05);两组治疗6个月VAS评分比较无统计学意义(P>0.05)。治疗后3d、3个月以及6个月,两组患者Oswestry功能障碍指数均有明显改善,与治疗前比较差异具有统计学意义(P<0.05);治疗后3d以及术后第3个月,A组与B组Oswestry功能障碍指数比较,差异有统计学意义(P<0.05);治疗后6个月,两组Oswestry功能障碍指数比较差异无统计学意义(P>0.05)。A组出现2例邻近椎体骨折,B组出现12例邻近椎体骨折,B组邻近椎体骨折率较A组高,差异有统计学意义(P<0.05)。结论经皮椎体成形术治疗老年性骨质疏松性椎体压缩性骨折是一种简单快速、疗效确实的手术方法,患者疼痛症状以及生活质量均有明显改善,骨水泥均匀弥散分布,早期疗效显著,邻近椎体再骨折率较低,值得优先选择。Objective To explore the effect of different dispersion patterns of bone cement in the injured vertebral body on postoperative analgesic efficacy and the risk of refracture during vertebroplasty for osteoporotic vertebral compression fractures.Methods A total of 202 patients(age range,58-82 years;mean age,68.2 years)with single-segment osteoporotic vertebral compression fractures admitted to the Second Affiliated Hospital of Inner Mongolia Medical University from October 2019 to December 2021 were included.There were 112 patients with lumbar vertebral fractures and 90 with thoracic vertebral fractures,all of whom underwent percutaneous vertebroplasty.Based on postoperative imaging data,the patients were divided into uniform and symmetric dispersion group(group A)and eccentric and asymmetric dispersion group(group B)according to the dispersion pattern and left-right symmetry of bone cement in the injured vertebral body.Visual analogue scale(VAS)pain score,Oswestry disability index(ODI),and adjacent vertebral refracture rate of the two groups were statistically analyzed and compared before and after surgery.Results All the patients were followed up for more than 1 year.Before treatment,no statistically significant difference in VAS pain score was found between the two groups(P>0.05).On the 3rd postoperative day,and at the 3rd and 6th postoperative months,VAS pain scores all reduced significantly in the groups A and B,with differences from those before treatment(P<0.05).The VAS pain score on the 3rd postoperative day showed a difference between the group A and the group B(P<0.05),but the VAS pain scores at the 3rd and 6th postoperative months had no differences(P>0.05).ODI was significantly improved in both groups 3 d,3 months and 6 months after treatment,with statistically significant differences compared with that before treatment(P<0.05).A significant difference between the group A and B was observed in ODI at 3 d after treatment(P<0.05),but not at 3 and 6 months after treatment(P>0.05).Adjacent vertebral refract

关 键 词：椎体成形术 骨质疏松性椎体压缩性骨折 骨水泥弥散 再骨折 

分 类 号：R683.2[医药卫生—骨科学]