倒角法单侧穿刺经皮椎体成形术治疗合并裂隙的单节段骨质疏松性椎体压缩性骨折的骨水泥弥散情况及临床疗效  

Bone cement dispersion and clinical efficacy of chamfering method unilateral puncture percutaneous vertebroplasty for single-level osteoporotic vertebral compression fractures with

作　　者：莫军 张思平 张焕文 杨涛[1] 付刚 伊力亚·伊利哈木 李建江[1] 黄异飞[1] Mo Jun;Zhang Siping;Zhang Huanwen;Yang Tao;Fu Gang;Yiliya·Yilihamu;Li Jianjiang;Huang Yifei(Second Department of Spinal Surgery,Traditional Chinese Medicine Hospital,Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学附属中医医院脊柱二科,乌鲁木齐830000

出　　处：《脊柱外科杂志》2025年第2期88-93,共6页Journal of Spinal Surgery

基　　金：“天山英才”培养计划科技创新领军人才项目(2022TSYCLJ0027)。

摘　　要：目的评价倒角法单侧穿刺经皮椎体成形术(PVP)治疗合并裂隙的单节段骨质疏松性椎体压缩性骨折(OVCF)的骨水泥弥散情况及临床疗效。方法回顾性分析2023年1月—2023年12月采用PVP治疗的63例合并椎体裂隙的单节段OVCF患者临床资料,其中32例采用常规穿刺方法(A组),31例采用倒角法单侧穿刺(B组)。记录并观察2组患者骨水泥注入量、骨水泥渗漏情况、骨水泥弥散类型及骨折椎体是否进一步塌陷等情况。手术前后采用疼痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI)评价疼痛程度及功能状态。结果所有手术顺利完成,所有患者随访时间>6个月,未出现定位错误、神经损伤、切口感染等严重并发症。B组骨水泥注入量高于A组,差异有统计学差异(P<0.05)。术后3个月A组发生骨水泥渗漏17例(17/32,53.1%),其中C型11例、B形5例、S形1例;B组发生骨水泥渗漏9例(9/31,29.0%),其中C型7例、S形2例;A组骨水泥渗漏率高于B组,差异有统计学意义(P<0.05)。A组骨水泥弥散程度,3型16例,1、2型各8例;B组31例均为3型弥散;2组骨水泥弥散程度差异有统计学意义(P<0.05)。末次随访时,2组VAS评分和ODI较术前显著改善,差异均有统计学意义(P<0.05),组间差异均无统计学意义(P>0.05)。末次随访时,A组1例发生骨折椎体再塌陷,B组无骨折椎体再塌陷情况发生。结论倒角法单侧穿刺PVP治疗合并裂隙的单节段OVCF可获得与传统PVP相同的临床疗效,且骨水泥弥散情况更好,骨水泥渗漏率更低,值得在临床中推广应用。Objective To evaluate the bone cement dispersion and clinical efficacy of chamfering method unilateral puncture percutaneous vertebroplasty(PVP)for single-level osteoporotic vertebral compression fractures(OVCF)with clefts.Methods From January 2023 to December 2023,the clinical data of 63 patients with single-level 0VCF with clefts treated with PVP were retrospectively analyzed.Among them,32 cases were treated with conventional puncture method(group A),and 31 with chamfering method unilateral puncture(group B).The amount of bone cement injection,cement leakage,cement dispersion type,and whether the fractured vertebral body further collapses in the 2 groups were recorded and observed.Pain intensity and functional status were evaluated using the visual analog scale(VAS)score and Oswestry disability index(ODI)at pre-and post-operation.ResultsAll the surgeries were successfully completed,and all the patients were followed up for more than 6 months without any serious complications such as positioning errors,nerve damage or incision infections.The injection amount of bone cement in group B was higher than that in group A,and the difference was statistically significant(P<0.05).At postoperative 3 months,17 cases(17/32,53.1%)of bone cement leakage occurred in group A,including 11 of type C,5 of type B,and 1 of type S;9(9/31,29.0%)of bone cement leakage occurred in group B,including 7 of type C and 2 of type S;the leakage rate of bone cement in group A was higher than that in group B,and the difference was statistically significant(P<0.05).The dispersion degree of bone cement in group A was 16 cases of type 3,8 of type 1 and 8 of type 2;31 in group B were all type 3 dispersion;there was a statistically significant difference in the dispersion degree of bone cement between the 2 groups(P<0.05).At the final follow-up,both groups showed significant improvement in VAS scores and ODI compared to the preoperative levels,all with a statistically significant difference(P<0.05).There was no statistically significant difference in

关 键 词：胸椎 腰椎 骨折 压缩性 骨质疏松 骨代用品 椎体成形术 

分 类 号：R683.2[医药卫生—骨科学]