摘要
目的评价经皮带球囊支架系统植入椎体成形术(VBS)治疗老年骨质疏松性椎体压缩骨折的安全性和临床疗效。方法纳入老年性骨质疏松性椎体压缩骨折患者38例,根据住院号奇偶数随机分成两组,分别采用VBS治疗和传统经皮球囊扩张椎体后凸成形术(PKP)治疗。通过对患者手术前后疼痛情况和功能改善情况、椎体压缩等影像学变化、矢状面Cobb角度变化以及骨水泥渗漏情况等相关指标对比分析,评估VBS的安全性和临床有效性。结果手术均由同一术者完成,手术方式均采用局部麻醉下经皮双侧穿刺法,试验组和对照组所有病例均安全顺利完成。所有病例均经半年以上随访,术后3 d、术后1个月、3个月及半年随访VAS评分和ODI功能障碍指数,均较术前明显改善,差异有统计学意义(P<0.05)。术后3 d、术后1个月、术后3个月及半年随访,试验组和对照组骨折椎体高度较术前均有明显改善,差异有统计学意义(P<0.05)。Cobb角均较术前有明显改善,差异有统计学意义(P<0.05);试验组和对照组相应指标对比分析,差异有统计学意义(P<0.05)。结论VBS治疗老年骨质疏松性椎体压缩骨折,在骨折椎体高度的恢复、骨折疼痛的缓解方面均有显著疗效,且骨水泥渗漏等并发症发生率低,是一种治疗老年骨质疏松性椎体压缩骨折的有效方法。
Objective To evaluate the safety and efficacy of balloon-expandable vertebral body stenting(VBS)in treating elderly patients with osteoporotic vertebral compression fractures.Methods Thirty-eight elderly patients with osteoporotic vertebral compression fractures were randomly divided into two groups according to the parity of their hospital admission numbers to receive VBS and traditional percutaneous kyphoplasty(PKP),respectively.The two groups were compared regarding changes in the intensity of pain,functional score,imaging parameters related to vertebral compression,and sagittal Cobb angle as well as the incidence of bone cement leakage after treatment,to evaluate the safety and efficacy of VBS.Results All the patients underwent the operations smoothly,which were performed with the bilateral percutaneous puncture technique under local anesthesia by the same surgeon,and were followed up for more than half a year.Both VBS group and PKP group showed significant improvement in the visual analogue scale score,the Oswestry disability index,the height of the fractured vertebral body,and the Cobb angle at 3 days,1 month,3 months and 6 months after treatment(all P<0.05).There were significant differences in those indicators between the two groups(all P<0.05).Conclusion VBS is an effective treatment approach for elderly patients with osteoporotic vertebral compression fractures.It can effectively recover fractured vertebral body height,relieve patients’pain,and have fewer complications such as bone cement leakage.
作者
仉培武
郭华
严少荣
庞捷
姬钢
王涛
杨熙创
ZHANG Peiwu;GUO Hua;YAN Shaorong;PANG Jie;JI Gang;WANG Tao;YANG Xichuang(Xi’an Central Hospital Affiliated,Medical College of Xi’an Jiaotong University,Xi’an 710003,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2022年第1期63-68,共6页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
西安市卫生健康委员会科技计划项目(No.2021Y607)。
关键词
VBS
经皮椎体后凸成形术
骨质疏松性椎体骨折
vertebral body stenting
percutaneous kyphoplasty
osteoporotic vertebral compression fracture
