经皮椎体成形术中应用骨水泥温度控制联合靶点灌注技术治疗骨质疏松性胸腰椎压缩骨折的疗效  

Application of temperature control combined with target perfusion technology of bone cement in percutaneous vertebroplasty

作　　者：李正兴 韩庭良 田林 孙昭杰 董松林[1] 马勇[1,2] Zheng-xing;HAN Ting-liang;TIAN Lin;SUN Zhao-jie;DONG Song-lin;MA Yong(Yancheng TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Yancheng,Jiangsu,224001,China)

机构地区：[1]南京中医药大学附属盐城中医院(盐城市中医院)骨伤科,江苏省224001 [2]南京中医药大学中医学院,中西医结合学院,江苏省210029

出　　处：《中国骨与关节杂志》2025年第4期295-302,共8页Chinese Journal of Bone and Joint

基　　金：江苏省卫生健康委员会项目(Z2023033);盐城市科技局科研项目(YCBK2023046);盐城市卫生健康委员会项目(YK2023015)。

摘　　要：目的比较骨水泥温度控制联合靶点灌注技术与传统骨水泥灌注技术,探讨其在经皮椎体成形术(percutaneous vertebroplasty,PVP)中应用以治疗骨质疏松性胸腰椎压缩骨折的疗效。方法回顾分析2021年1月至2022年12月南京中医药大学附属盐城中医院收治的93例骨质疏松性胸腰椎单椎体压缩骨折患者的临床资料,男18例,女75例;年龄52~96岁,平均(74.49±0.99)岁。均采用PVP治疗,其中45例采用温度控制联合靶点灌注技术(联合组),48例采用传统穿刺注射技术(传统组)。比较两组患者手术时间、骨水泥弥散总面积比值、骨水泥渗漏率、邻近椎体骨折发生率及术前、术后1天及末次随访时疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、病椎前缘压缩率、病椎Cobb’s角等情况。结果本组随访时间12~20个月,平均(15.76±0.27)个月。两组患者手术时间、术前及术后1天的椎体前缘压缩率、病椎Cobb’s角、VAS评分、ODI差异无统计学意义(P>0.05)。末次随访时联合组VAS评分为2(1,2)分,低于传统组的2(1,3)分(P<0.05)。末次随访时联合组ODI 16.64±0.98低于传统组的20.37±1.38(P<0.01)。末次随访时联合组病椎前缘压缩率(19.36±1.73)%,低于传统组的(25.72±1.76)%(P<0.01)。末次随访时联合组病椎Cobb’s角(8.92±0.58)°,低于传统组的(10.26±0.54)°(P<0.05)。联合组骨水泥弥散总面积比值0.64±0.01明显高于传统组的0.57±0.01(P<0.01)。联合组3例(6.7%)发生骨水泥渗漏,传统组13例(27.1%)发生骨水泥渗漏(P<0.05)。联合组在随访期间内有1例(2.2%)发生邻近椎体骨折,而传统组8例(16.7%)发生邻近椎体骨折(P<0.05)。结论PVP中运用骨水泥温度控制联合靶点灌注技术和运用传统穿刺注射技术治疗骨质疏松性胸腰椎压缩骨折均可取得满意的疗效,但前者具有减少PVP术后椎体前缘高度及Cobb’s角再丢失、降低术后慢性后背�Objective To compare the temperature control of bone cement combined with targeted perfusion technology with that of traditional bone cement perfusion technology,and to explore the therapeutic efficacy of its application in percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar compression fractures.Methods A retrospective cohort study was conducted to analyze the clinical data of 93 patients with osteoporotic thoracolumbar vertebral compression fractures admitted to Yancheng Traditional Chinese Medicine Hospital affiliated with Nanjing University of Chinese Medicine from January 2021 to December 2022.The cohort included 18 males and 75 females,aged 52-96 years(mean,74.49±0.99 years).All patients were treated with percutaneous vertebroplasty;45 cases underwent temperature control combined with targeted perfusion technology(combined group),and 48 cases underwent traditional puncture injection(traditional group).We compared surgical time,total area of bone cement diffusion ratio,bone cement leakage rate,incidence of adjacent vertebral fractures,as well as the visual analog scale(VAS),Oswestry functional impairment index(ODI),anterior vertebral compression rate,Cobb’s angle,and other conditions before and after surgery and at the last follow-up between two groups.Results All patients were followed up for 12-20 months(mean:15.76±0.27 months).There was no statistically significant difference(P>0.05)in surgical time,anterior vertebral compression rate,Cobb’s angle,VAS,and ODI between the two groups of patients before and 1 day after surgery.At the last follow-up,the VAS score of the combined group was 2(1,2)points,which was lower than the traditional group’s 2(1,3)points(P<0.05).At the last follow-up,the ODI of the combined group was(16.64±0.98)%,which was lower than that of the traditional group(20.37±1.38)%(P<0.01).At the last follow-up,the anterior vertebral compression rate of the combined group was(19.36±1.73)%,which was lower than that of the traditional group(25.72±1.76)%(P<0.01)

关 键 词：椎体成形术 骨质疏松性骨折 温度 靶点灌注 

分 类 号：R683.2[医药卫生—骨科学]