摘要
目的探讨经皮穿刺椎体成形术(PVP)入路选择对老年骨质疏松性骨折患者术后脊柱矢状面重建的临床疗效。方法收集2016年3月至2020年3月我院80例老年骨质疏松性骨折患者临床资料进行回顾性分析,40例行单侧PVP为单侧组,40例行双侧PVP为双侧组。统计两组手术情况、并发症、经济学及手术前后脊柱矢状面重建参数[骨盆入射角(PI)、胸椎后凸角(TK)、腰椎前凸角(LL)]、椎旁肌肌电变化[静息状态下、伸展躯干状态下椎旁肌平均肌电值(AEMG)及拾物保持状态下平均功率频率斜率(MPFs)]、腰椎功能(JOA)、疼痛程度(VAS)、日常生活能力(ADL)。结果单侧组手术时间短于双侧组,透视次数少于双侧组,骨水泥用量少于双侧组,差异有统计学意义(P<0.05);术后3个月单侧组静息状态下AEMG及拾物保持状态下MPFs低于双侧组,伸展躯干状态下AEMG高于双侧组,差异有统计学意义(P<0.05);术后3个月、6个月两组PI、LL高于术前,TK低于术前,差异有统计学意义(P<0.05),但组间对比,差异无统计学意义(P>0.05);术后3个月、6个月两组JOA、VAS评分低于术前,ADL评分高于术前,差异有统计学意义(P<0.05),但组间对比,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);单侧组直接医疗费少于双侧组,差异有统计学意义(P<0.05)。结论单侧与双侧PVP治疗老年骨质疏松性骨折均能取得良好效果,改善患者脊柱矢状位平衡状态,而单侧PVP具有手术时间短、透视次数少、直接医疗费低等优势,并可早期改善椎旁肌肉功能状态。
Objective To explore the clinical effect of percutaneous vertebroplasty(PVP)approach selection for postoperative spine sagittal reconstruction and economics in elderly patients with osteoporotic fractures. Methods From March 2016 to March 2020, clinical data of 80 elderly patients with osteoporotic fractures in our hospital were collected for retrospective analysis. 40 cases of unilateral PVP were set as unilateral group, and 40 cases of bilateral PVP were set as bilateral group. Operation status, complications, economics and parameters of sagittal reconstruction of spine, including pelvic incidence angle(PI), thoracic kyphosis angle(TK), lumbar lordosis angle(LL)before and after operation, and electromyographic changes of paraspinal muscles, including average paraspinal muscle EMG(AEMG)in resting state and trunk stretched, and mean power frequency slope(MPFs)in pick-up holding state, lumbar spine function(JOA), pain degree(VAS)and ability of daily living(ADL)were calculated. ResultsOperation time of unilateral group was shorter than that of bilateral group, number of fluoroscopy was less than that of bilateral group, and amount of bone cement was less than that of bilateral group(P<0.05). Three months after operation, AEMG of unilateral group at rest and MPFs under pick-up holding state were lower than those of bilateral group, and AEMG under trunk stretched state was higher than that of bilateral group(P<0.05). PI and LL of two groups were higher than before operation at 3 and 6 months after operation, and TK was lower than before operation(P<0.05), but there was no significant difference between groups(P>0.05). Scores of JOA and VAS were lower than before operation at 3 months and 6 months after operation, and scores of ADL were higher than before operation(P<0.05), but there was no significant difference between groups(P>0.05). There was no significant difference in the incidence of complications between two groups(P>0.05). The direct medical expenses of unilateral group were less than that of bilateral group
作者
辜琴
Gu Qin(Panzhihua Central Hospital,Panzhihua,Sichuan 617000,China)
出处
《四川医学》
CAS
2022年第2期153-158,共6页
Sichuan Medical Journal
关键词
单侧
双侧
经皮穿刺椎体成形术
骨质疏松性骨折
脊柱矢状面重建
椎旁肌肌电
unilateral
bilateral
percutaneous vertebroplasty
osteoporotic fractures
spine sagittal reconstruction
paraspinal muscle electromyography
