摘要
【目的】探讨椎体成形术(PVP)中骨水泥在椎体内呈"倒U型"分布的临床疗效。【方法】回顾性分析我院从2009年6月至2016年8月间行单一椎体PVP(低黏度骨水泥)手术的患者,根据X线及CT骨水泥的分布情况分为两组。A组:完整的"倒U型"分布(椎体前缘有骨水泥连接);B组:未形成完整的"倒U型"分布(椎体前缘无骨水泥连接)。评价术前、术后3 d,末次随访的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、局部后凸(Cobb)角,随访中间的相邻椎体骨折也被评价。【结果】83个行低黏度骨水泥PVP手术的患者纳入我们的研究,包括37个"倒U型"分布和46个不完整"倒U型"分布的椎体,随访时间1~2年。所有患者术后3 d疼痛均较术前明显缓解(P<0.05),A组术后3 d VAS较B组缓解更为显著(P<0.05),末次随访两组差异无统计学意义(P>0.05)。两组ODI结果和VAS评分结果相似。术后3 d局部Cobb角两组均较术前改善(P<0.05),两组末次随访局部Cobb角均未见明显丢失(P>0.05)。A组和B组分别出现了2和4例相邻椎体骨折,提示差异无统计学意义(P>0.05)。【结论】骨水泥在椎体内呈"倒U型"分布是影响PVP临床疗效的因素之一,尤其是在术后疼痛快速缓解方面。另外,骨水泥在椎体侧壁和前柱的充填非常重要,它是预防椎体再塌陷的重要因素之一。
【Objective】To investigate clinical effect of bone cement distribution of＂inverted U＂style in the injuredvertebral body in percutaneous vertebroplasty（PVP）procedure.【Methods】From June 2009 to August 2016,the patientswho underwent PVP using low-viscosity cement for treating single vertebral fracture were reviewed in our hospital. Thepatients were divided into two groups according to CT and X-ray image of bone cement distribution. Group A ：bonecement was presented as a complete＂inverted U＂type in the vertebral body（the bone cement was interconnected at theanterior edge of vertebral body）;group B：A complete＂inverted U＂type distribution was unformed（the bone cementwas not interconnected at the anterior edge of vertebral body）. The data about visual analogue scale（VAS）,OswestryDisability Index（ODI）and Cobb angle before operation,at the 3 rd day after operation,and at the final follow-up werecollected and evaluated. Adjacent vertebral fracture was also evaluated during the follow-up. 【Results】Eighty-threepatients who had PVP procedures with low-viscosity cement,including 37 vertebrae with＂inverted U＂type distributionand 46 vertebrae with incomplete＂inverted U＂type distribution,were reviewed in our study. The follow-up was 1 to 2 years. The patients′ pain in both groups were obviously relieved at the 3 rd day after operation（P〈0.05）. The VAS in theA group was more lower than that in the B group（P〈0.05）. There was no difference at the final follow-up between the twogroups（P〉0.05）. A similar result occurred for ODI between them. The Cobb angle at the post-operation 3 rd day in both groups significantly improved compared with that at the pre-operation（P〈0.05）. There was no obvious loss for Cobb angle at the final follow-up in the two groups（P〉0.05）. The number of patients with adjacent vertebral fracture occurred in the A and B group were 2 and 4,respectively（P〉0.05）.【Conclusions】The＂inverted U＂distribution of bone cement i
作者
黄荷
张兆飞
谢春亮
刘栋华
HUANG He;ZHANG Zhao-fei;XIE Chun-liang;LIU Dong-hua(Department of Orthopedic Surgery,Guangzhou Hospital of Integrated Traditional and West Medicine,Guangzhou 510800,China)
出处
《中山大学学报（医学版）》
CAS
CSCD
北大核心
2018年第4期554-559,共6页
Journal of Sun Yat-Sen University:Medical Sciences
关键词
经皮椎体成形术
倒U型
水泥分布
pereutaneous vertebroplasty
＂inverted U＂ type
distribution of bone cement
