摘要
目的研究骨水泥分布对单节段骨质疏松性胸腰椎椎体骨折并行椎体成形手术的影响。方法选取2013月7月—2016年12月因单节段骨质疏松性胸腰椎骨折在我院接受椎体成形术的患者为研究对象,评估骨水泥分布指数及骨水泥弥散情况、椎体影像学参数及功能参数、血清骨代谢指标。结果手术前不同骨水泥分布指数患者的Cobb角度、椎体前缘压缩率、Oswestry功能障碍指数(ODI)评分、疼痛视觉模拟(VAS)评分、血清β-CTX和PINP含量比较差异无统计学意义(P>0.05)。末次随访时,不同骨水泥分布指数骨水泥患者的分Cobb角度、椎体前缘压缩率、ODI评分、VAS评分均低于治疗前,且Ⅳ~Ⅴ级患者低于Ⅰ~Ⅲ级患者(P<0.05)。不同程度骨水泥弥散患者的Cobb角度、椎体前缘压缩率、ODI评分、VAS评分均较治疗前降低,且骨髓弥散程度充分者的上述指标明显低于骨水泥弥散不充分患者(P<0.05);不同骨水泥分布指数和不同程度骨水泥弥散程度患者的血清PINP含量高于手术前、β-CTX含量低于手术前(P<0.05)。骨水泥分布指数Ⅳ~Ⅴ级患者的血清PINP含量高于Ⅰ~Ⅲ级患者,β-CTX含量低于骨水泥分布指数Ⅰ~Ⅲ级患者(P<0.05);骨水泥充分弥散患者的血清PINP含量高于弥散不充分患者、β-CTX含量低于弥散不充分患者(P<0.05)。结论骨水泥分布指数降低、弥散程度不足会影响单节段骨质疏松性胸腰椎椎体骨折并行椎体成形手术的效果。
Objective To study effect of bone cement distribution on single-segment osteoporotic thoracolumbar vertebral fracture in patients undergoing vertebroplasty. Methods Patients with single-segment osteoporotic thoracolumbar vertebral fractures in patients undergoing vertebroplasty during July 2013 and December 2016 were recruited in this study. Distribution index of bone cement,dispersion condition of bone cement,vertebral imaging parameters and functional parameters,and serum indexes of bone metabolism were evaluated. Results There were no significant differences in values of Cobb angle,compression rate of vertebral anterior border,Oswestry dysfunction index (ODI) score,visual analogue scales (VAS) score,serum contents of β-CTX and PINP among patients with different distribution indexes of bone cement before operation (P > 0. 05). At the last follow-up,values of Cobb angle,compression rate of vertebral anterior border,ODI score and VAS score were significantly lower than those before treatment among patients with different distribution indexes of bone cement,and the values in grade Ⅳ-Ⅴ patients were significantly lower than those in grade Ⅰ-Ⅲ patients (P < 0. 05). Values of Cobb angle,compression rate of vertebral anterior border,ODI score and VAS score were significantly lower than those before treatment among patients with different degrees of bone cement dispersion,and the values in patients with adequate bone marrow diffusion were significantly lower than those in patients with insufficient bone marrow diffusion (P < 0. 05). After operation,serum PINP levels were significantly higher,while β-CTX contents were significantly lower than those before operation among patients with different bone cement distribution indexes and different degrees of bone marrow dispersion (P < 0. 05). In patients with grade Ⅳ-Ⅴ of bone cement distribution index,serum PINP levels were significantly higher,while β-CTX contents were significantly lower than those in patients with grade Ⅰ-Ⅲ of bone cement distribution i
作者
陈昆
周章南
蔡惠民
刘爱刚
陈荣滋
CHEN Kun;ZHOU Zhang-nan;CAI Hui-min;LIU Ai-gang;CHEN Rong-zi(Department of Orthopaedics,910 Hospital of PLA Joint Logistics Support Forces,Quanzhou,Fujian 362000,China)
出处
《解放军医药杂志》
CAS
2019年第8期57-61,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
2013年南京军区医药卫生科研基金项目(ZX22)
关键词
单节段骨质疏松性胸腰椎骨折
椎体成形术
骨水泥
骨代谢
Single-segment osteoporotic thoracolumbar vertebral fracture
Vertebroplasty
Bone cement
Bone metabolism
