摘要
目的分析腰椎骨折治疗干预中骨水泥用量及充盈水平与症状缓解程度的关联。方法 2015年1月—2016年12月河南新乡市中心医院应用椎体成形术治疗腰椎骨折患者158例,测定骨水泥的使用量以及充盈程度;评估患者症状恢复状态,评价对比骨折再发率、并发症发生率,分析术中骨水泥充盈程度与治疗后恢复状态之间的关系。结果骨水泥用量为(5. 66±1. 46) m L,充盈程度好的患者占54. 43%,中等占37. 34%,差的占8. 23%。患者治疗后6个月随访腰痛VAS评分减少(4. 71±0. 84)分,1年内的骨折再发率为1. 27%,并发症发生率为1. 90%。此外患者腰椎前凸Cobb角增加(9. 18±2. 41)°,腰椎侧凸Cobb角降低(6. 83±1. 20)°。分析受试对象术中骨水泥充盈程度与治疗后恢复状态之间的关系,提示腰痛减轻程度在充盈程度差的患者中最低,不同充盈程度患者之间差异有统计学意义(P <0. 05);充盈程度差的患者骨折再发率及并发症发生率均最高,不同充盈程度患者之间差异有统计学意义(P <0. 05);术中骨水泥用量与治疗后恢复状态各指标进行相关分析,结果提示骨水泥用量与治疗后腰痛VAS评分减少水平之间相关系数为-0. 164(P=0. 326),与腰椎前凸Cobb角和侧凸Cobb角变化水平之间的相关系数分别为0. 115(P=0. 102)和0. 218(P=0. 087)。结论腰椎骨折患者在行椎体成形手术中使用骨水泥的充盈程度会对治疗后恢复状态产生影响,腰痛降低程度在充盈程度差的患者中更低,充盈程度差的患者骨折再发率以及并发症发生率均最高。
Objective To analyze the relationship between the amount of bone cement dosage and the level of filling and the degree of symptom relief in the treatment of lumbar fractures.Methods A total of 158 patients with lumbar vertebrae fractures who underwent vertebroplasty in our hospital from Jan.2015 to Dec.2016 were selected to determine the amount of bone cement dosage and the degree of filling.The patients symptom recovery status were evaluated,and the fracture recurrence rate and complication rate were compared.Results The average level of bone cement dosage was(5.66±1.46)mL.The proportion of patients with good filling was 54.43%,with moderate filling of 37.34%and poor filling of 8.23%.In addition,the VAS score of low back pain of the patients at 6 months after treatment was reduced by an average of 4.71±0.84,the recurrence rate of fracture within 1 year was 1.27%,and the complication rate was 1.90%.In addition,the lumbar lordosis Cobb s angle increased by(9.18±2.41)°,and the lumbar scoliosis Cobb s angle decreased by(6.83±1.20)°.The relationship between the degree of bone cement filling and the recovery state after treatment was analyzed,suggesting that the relief degree of low back pain was lowest among patients with poor filling,and the difference between patients with different filling levels was statistically significant(P<0.05).In addition,the recurrence rate of fracture and the incidence of complications were highest in patients with poor filling,and the difference between patients with different filling levels was statistically significant(P<0.05).The correlation analysis between intraoperative bone cement dosage and post-treatment recovery status showed that the correlation coefficient between bone cement dosage and the reduction of post-treatment low back pain VAS score was-0.164(P=0.326),and its correlation coefficients with the change levels of lumbar lordosis Cobb s angle and scoliosis were 0.115(P=0.102)and 0.218(P=0.087),respectively.Conclusion The degree of bone cement filling in patients und
作者
史锐
SHI Rui(Department of Orthopaedics,Central Hospital of Xinxiang,Xinxiang,Henan 453000,China)
出处
《创伤外科杂志》
2019年第1期44-47,共4页
Journal of Traumatic Surgery
关键词
腰椎骨折
骨水泥
充盈
lumbar fracture
bone cement
filling
