弯角椎体成形术治疗胸腰椎骨质疏松性椎体压缩性骨折骨水泥分布特点及疗效分析  

Analysis of the Distribution Characteristics of Bone Cement and Clinical Efficacy in the Treatment of Osteoporotic Vertebral Compression Fractures by Percutaneous Curved Vertebroplasty

作　　者：张强 刘江川 杨帆 陈铭 范海泉 ZHANG Qiang;LIU Jiangchuan;YANG Fan(The Spine Surgery Department,the Second Affiliated Hospital of Chengdu Medical College,China National Nuclear Corporation 416 Hospital,Chengdu City,Sichuan Province 610000)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院脊柱骨科,四川省成都市610000

出　　处：《医学理论与实践》2025年第8期1276-1280,共5页The Journal of Medical Theory and Practice

摘　　要：目的:比较弯角椎体成形术(PCVP)与单侧穿刺入路椎体成形术(PVP)治疗胸腰椎骨质疏松性骨折(OVCF)其椎体内骨水泥分布特点和临床疗效,以验证PCVP价值。方法:通过回顾性分析我院2020年7月1日—2023年6月30日因OVCF住院治疗病例70例,根据手术方式不同分为PCVP组(32例)和PVP组(38例),均获得至少6个月随访资料。比较两组手术时间、X线透视次数、骨水泥注入量、伤椎Cobb角、伤椎前高比、横断位骨水泥分布理想率及面积、骨水泥矢状面上与上下终板分布情况、VAS评分及ODI指数、骨水泥渗漏、椎弓根皮质损伤指标。结果:PCVP组手术时间短于PVP组,X线透视次数少于PVP组,骨水泥注入量多于PVP组,PCVP组横断位骨水泥分布理想率及骨水泥分布面积大于PVP组(P<0.05),两组矢状位骨水泥分布与上下终版关系比较无明显差异(P>0.05)。术后1d及末次随访两组伤椎Cobb角、伤椎前高比较术前增加(P<0.05),但两组间比较无明显差别(P>0.05)。术后3d及末次随访两组VAS评分及ODI指数较术前降低(P<0.05),两组间比较无明显差别(P>0.05)。PCVP组骨水泥渗漏、椎弓根皮质损伤指标小于PVP组(P<0.05)。结论:PCVP与单侧椎弓根入路时PVP相比具有手术时间短、X线透视次数少、骨水泥分布更均匀更广、骨水泥渗漏及椎弓根皮质穿刺损伤风险更低的优点。Objective:The clinical efficacy and distribution characteristics of bone cement in the vertebra of osteoporotic vertebral compression fractures(OVCF)were compared between percutaneous curved vertebroplasty(PCVP)and unilateral puncture vertebroplasty(PVP)to verify the value of PCVP.Methods:From July 1st 2020 to June 30th 2023,70 patients with OVCF were analyzed retrospectively,the patients were divided into PCVP group(32 cases)and PVP group(38 cases),all patients were followed up for at least 6 months.The operation time,the times of X-ray fluoroscopy,the amount of cement injection,the Cobb angle,the anterior aspect ratio,the ideal rate and area of cement distribution,the distribution of cement on sagittal plane and upper and lower endplates,VAS score and ODI index,cement leakage,and pedicle cortical injury were compared between the two groups.Results:The time of operation in PCVP group were shorter than those in those in PVP group,and the times of X-ray fluoroscopy in PCVP group were less than those in PVP group(P<0.05),and the amount of bone cement injected in PCVP group was more than that in PVP group(P=0.043).The ideal rate of cement distribution and the area of cement distribution in PCVP group were higher than that in PVP group(P<0.05).There was no significant difference between the sagittal cement distribution and the relationship between the upper and lower final version(P>0.05).The Cobb angle and the anterior height of the injured vertebra were increased in the two groups at 1 day postoperatively and the last follow-up(P<0.05),but there was no significant difference between the two groups(P>0.05).The VAS score and ODI index of the two groups at postoperative day 3 and the last follow-up were lower than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The indexes of bone cement leakage and pedicle cortical damage in PCVP group were lower than those in PVP group(P<0.05).Conclusion:Compared with PVP through unilateral pedicle approach,PCVP has the advantage

关 键 词：弯角椎体成形 椎体成形 骨质疏松 胸腰椎骨折 

分 类 号：R683.2[医药卫生—骨科学]