摘要
目的探讨骨填充网袋椎体成形术、椎体成形术(PVP)、椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCF)的疗效。方法采用前瞻性对照病例分析研究对2015年3月—2018年2月深圳市龙岗区人民医院收治225例OVCF患者,应用随机数字表法及随机余数分组法将其分为网袋组(75例,采用骨填充网袋椎体成形术治疗)、PVP组(75例,采用PVP治疗)、PKP组(75例,采用PKP治疗)。网袋组:男性45例,女性30例;年龄52~81岁,平均62. 9岁;致伤原因:摔伤31例,道路交通伤40例,高处坠落伤1例,击打伤3例。PVP组:男性42例,女性33例;年龄54~80岁,平均63. 3岁;致伤原因:摔伤33例,道路交通伤41例,击打伤1例。PKP组:男性46例,女性29例;年龄51~82岁,平均64. 8岁;致伤原因:摔伤29例,道路交通伤44例,高处坠落伤2例。比较三组围手术期相关指标、伤椎前缘高度、矢状位后凸Cobb角、疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分及并发症的发生率。结果 PVP组手术时间(32. 27±6. 52) min,短于PKP组(38. 36±5. 79) min和网袋组(37. 43±3. 79) min,差异有统计学意义(P <0. 05)。PVP组、PKP组、网袋组术后3d伤椎前缘高度分别为(20. 06±1. 65) mm、(20. 15±1. 85) mm、(19. 73±1. 78) mm,术后6个月分别为(22. 12±1. 54) mm、(22. 36±1. 63) mm、(22. 39±1. 72) mm,术后12个月分别为(23. 97±1. 68) mm、(24. 12±1. 54) mm、(24. 00±1. 25) mm,均高于治疗前的(16. 49±1. 46) mm、(16. 27±1. 38) mm、(16. 73±1. 44) mm(P <0. 05),但组间同时间点比较差异无统计学意义(P> 0. 05)。术后3d、6个月、12个月矢状位后凸Cobb角PKP组分别为(10. 35±1. 57)°、(8. 13±1. 17)°、(8. 24±1. 2)°,网袋组分别为(10. 83±2. 15)°、(7. 99±1. 22)°、(8. 01±1. 30)°,PVP组分别为(14. 26±2. 32)°、(12. 62±0. 35)°、(12. 03±0. 31)°,PKP组和网袋组显著小于PVP组,差异有统计学意义(P <0. 05)。术后3d、6个月、12个月网袋组VAS评分分别为(2. 61±
Objective To explore the efficacy of bone filling mesh bag vertebroplasty,percutaneous vertebroplasty( PVP) and percutaneous kyphoplasty( PKP) in the treatment of osteoporotic vertebral compression fractures( OVCF). Methods Prospective control case analysis was used in the study. Totally 225 patients with OVCF who were admitted to Longgang District People’s Hospital of Shenzhen from Mar. 2015 to Feb. 2018 were selected,which were divided into mesh bag group( 75 cases,treated by bone filling mesh bag vertebroplasty),PVP group( 75 cases,treated by PVP),and PKP group( 75 cases,treated by PKP) according to the random number table and random remainder group method. Mesh bag group: 45 males and 30 females,aged 52-81 years,average 62. 9 years;causes of injuries: 31 falls,40 traffic injuries,1 fall from height,and 3 injuries by beat. PVP group: 42 males and 33 females;aged 54-80 years,average 63. 3 years;causes of injury: 33 falls,41 traffic injuries,and 1 injury by beat.PKP group: 46 males and 29 females;aged 51-82 years,average 64. 8 years;causes of injury: 29 falls,44 traffic injuries,and 2 falls from height. The perioperative indexes,anterior height of injured vertebrae,sagittal kyphosis Cobb’s angle,visual analogue scale( VAS),Oswestry dysfunction index( ODI) and the incidence of complications were compared among the three groups. Result The operation time of PVP group was( 32. 27 ± 6. 52) min,which was shorter than( 38. 36 ± 5. 79) min of PKP group and( 37. 43 ± 3. 79) min of mesh bag group,and the difference was statistically significant( P < 0. 05). The anterior height of injured vertebrae at 3 d,6 months and 12 months after surgery was( 20. 06 ± 1. 65) mm,( 20. 15 ± 1. 85) mm,( 19. 73 ± 1. 78) mm in the PVP group,was( 22. 12 ± 1. 54)mm,( 22. 36 ± 1. 63) mm,( 22. 39 ± 1. 72) in the PKP group and was( 23. 97 ± 1. 68) mm,( 24. 12 ± 1. 54) mm,( 24. 00 ± 1. 25) mm in the mesh bag group,which were higher than( 16. 49 ± 1. 46) mm,( 16. 27 ± 1. 38) mm,( 16. 73 ± 1. 44) mm before surgery( P < 0. 05),bu
作者
林学扬
朱智奇
刘振华
王德桂
杨建华
饶海军
高梁斌
LIN Xue-yang;ZHU Zhi-qi;LIU Zhen-hua;WANG De-gui;YANG Jian-hua;RAO Hai-jun;GAO Liang-bin(Department of Spinal Surgery,Longgang District People's Hospital of Shenzhen,Shenzhen,Guangdong 518172,China;Department of Spinal Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou510285,China;Department of Orthopaedics,Sun Yixian Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China)
出处
《创伤外科杂志》
2020年第8期600-605,共6页
Journal of Traumatic Surgery
基金
广东省医学科研基金项目(B20161128)
深圳市医疗卫生科技计划项目(LGKCYLW2018000197)。
关键词
椎体压缩性骨折
骨质疏松
骨填充网袋
成形术
vertebral compression fracture
osteoporosis
bone filling mesh bag
vertebroplasty
