摘要
目的探讨PKP技术治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral body compression fracture,OVCF)的临床疗效,并探讨术后骨水泥渗漏的相关因素。方法自2012-06-2015-06,采用PKP治疗OVCF患者153例,术后随访1年以上,分别于术前、术后3 d和末次随访时统计其VAS评分和ODI指数的改善情况,以及伤椎高度、Cobb角的矫正情况。依据患者术后发生骨水泥渗漏与否,将其分为骨水泥渗漏组及未渗漏组,分别对两组患者术前Cobb角、椎体高度、骨折新鲜度、椎体周壁有无破坏、单侧或双侧入路、伤椎骨水泥注入量等可能的相关因素进行统计学分析。结果 153例术后随访13-21个月,平均15.2个月。与术前相比,所有患者术后3 d及末次随访时的VAS、ODI评分均较术前有显著下降(P<0.05);其伤椎Cobb角与椎体前中柱的平均高度亦有明显矫正,与术前相比有显著性差异(P<0.05)。术后,共21例发生骨水泥渗漏(发生率13.7%),将其作为渗漏组,另132例作为未渗漏组,对两组患者的相关因素进行组间单因素分析提示,椎体周壁有无破坏、骨水泥用量和术前伤椎高度3项指标,在组间有显著性差异(P<0.05);进一步行多因素Logistic回归分析,椎体周壁破坏、骨水泥用量这2项因素,均是PKP术后骨水泥渗漏的独立危险因素(P<0.05)。结论 OVCF患者行PKP技术治疗,可取得良好的疗效,但术后仍难以避免骨水泥渗漏问题。骨水泥注入量较多、椎体周壁有破损,均是发生骨水泥渗漏的独立危险因素,应引起临床重视。
Objective To investigate the clinical efficacy of PKP technique in the treatment of osteoporotic vertebral compression fractures（OVCF） and to explore the related factors of the postoperative bone cement leakage. Methods From June 2012 to June 2015, 153 OVCF patients with PKP therapy were followed up for more than 1 year. The improvement of VAS score and ODI index, the vertebral height, Cobb angle correction were evaluated before and 3 d after operation and at last follow-up. According to the occurrence of postoperative bone cement leakage, the patients were divided into bone cement leakage group and no leakage group.. The preoperative Cobb angle, vertebral height, fresh degree, fracture of vertebral body wall damage, unilateral or bilateral approach, the injury vertebral cement injection, possible related factors in two groups were statistically analyzed. Results153 cases were followed up for 13-21 months, with an average of 15.2 months. Compared with before operation, 3 d after operation and at last follow-up, the VAS and ODI scores of all patients weresignificantly decreased（P〈0.05）; the vertebral Cobb angle and anterior column average height significantly corrected, there was significant difference compared with preoperation（P〈0.05）. After operation, a total of 21 cases of bone cement leakage（13.7%） were selected as the leakage group,another 132 cases without bone cement leakage were selected as no leakage group. The related factors of two groups were compared by the single factor analysis, the results showed that vertebral body wall damage, bone cement and preoperative vertebral height had significant differences between two groups（P〈0.05）; further Logistic regression analysis showed that the vertebral body wall damage, the amount of bone cement were the independent risk factors of postoperative PKP（P〈0.05）. Conclusion PKP technique can achieve good results in OVCF patients, but it is difficult to avoid bone cement leakage after operation. The amount of bone cement injected and
出处
《颈腰痛杂志》
2018年第1期14-17,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
骨质疏松性椎体压缩骨折
PKP技术
骨水泥渗漏
相关因素
osteoporotic vertebral compression fractures
PKP technology
bone cement leakage
related factors
