摘要
目的比较球囊二次扩张椎体后凸成形术与骨填充网袋椎体成形术治疗伴后壁破裂的单节段骨质疏松性椎体压缩骨折(OVCFs)的疗效。方法回顾性研究2018年1月—2020年1月重庆市中医骨科医院骨科收治的伴后壁破裂单节段OVCFs患者60例,男性21例,女性39例;年龄60~88岁,平均67.7岁。致伤原因:扭伤22例,跌倒伤24例,无明确诱因14例。根据手术方式不同分为球囊组和网袋组,各30例,球囊组行球囊扩张椎体后凸成形术,网袋组行骨填充网袋椎体成形术。比较两组患者手术时间、术中出血量、骨水泥使用量、骨水泥分布、骨水泥渗漏情况、术后住院时间和相关医疗费用。术前、术后3d及末次随访时胸腰椎侧位X线片测量伤椎前缘高度和局部后凸Cobb角,采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评价患者生活质量。结果两组患者术后3d和末次随访时VAS和ODI均较术前显著改善(P<0.05);术后3d和末次随访球囊组VAS[(2.2±0.9)分、(1.8±1.0)分]和ODI[25.2±4.0、22.6±4.1]与网袋组VAS[(2.1±1.0)分、(1.6±0.9)分]和ODI[26.1±7.0、23.3±4.2]比较,差异无统计学意义(P>0.05)。两组患者术后3d及末次随访时伤椎前缘高度比和后凸Cobb角均较术前显著改善(P<0.05),且球囊组伤椎高度的恢复和后凸畸形的矫正显著优于网袋组[(19.7±12.6)%vs.(13.8±6.2)%、(-5.5±1.3)°vs.(-4.7±1.0)°];术后3d和末次随访球囊组伤椎前缘高度比[(81.8±10.4)%、(79.8±10.9)%]、后凸Cobb角[(15.2±3.9)°、(15.8±4.0)°]与网袋组伤椎前缘高度比[(76.8±6.9)%、(75.0±7.0)%]、后凸Cobb角[(17.3±3.6)°、(18.0±3.8)°]比较,差异有统计学意义(P<0.05)。球囊组手术时间[(41.3±5.1)min]、术中出血量[(14.3±3.6)mL]和住院天数[(3.1±0.8)d]与网袋组[(39.6±4.0)min、(14.8±4.5)mL、(3.4±1.1)d]比较,差异无统计学意义(P>0.05);球囊组术中骨水泥充填量(5.1±0.9)mL显著多于网袋组(3.5±0.8)mL,但人均住院费用(3.3�
Objective To explore the clinical effect of kyphoplasty with movement and secondary enlargement of balloon and bone filling vertebroplasty for the treatment of osteoporotic vertebral compression fractures(OVCFs)with broken posterior wall.Methods The clinical data of 60 patients with single-level OVCFs with broken posterior wall who were diagnosed and treated in the Department of Orthopaedics of Chongqing Orthopaedic Hospital of Traditional Chinese Medicine from Jan.2018 to Jan.2020 were retrospectively analyzed.There were 21 males and 39 females,with an average age of 67.6 years(range,60 to 88 years).There were 22 cases of sprain injury,24 cases of fall injury and 14 cases of no clear causes.Thirty patients who underwent kyphoplasty with movement and secondary enlargement of balloon were assigned into balloon group,while thirty patients who underwent bone filling vertebroplasty were assigned into vesseplasty group.The operation time,intra-operative blood loss,bone cement consumption,bone cement distribution,bone cement leakage,postoperative hospital stay and relative medical cost were compared between the two groups.The compression ratio of anterior vertebral height and cobb kyphotic angle were measured before operation,3 days after operation and at the final follow-up.The quality of life was evaluated by visual analog scale(VAS)and Oswestry disability index(ODI).Results The VAS and ODI of two groups were significantly improved postoperatively and at final follow-up(P<0.05).At 3 days after operation and final follow-up,there was no significantly difference between VAS[(2.2±0.9)points,(1.8±1.0)points],ODI(25.2±4.0,22.6±4.1)for balloon group and VAS[(2.1±1.0)points,(1.6±0.9)]points,ODI(26.1±7.0,23.3±4.2)for vesselplasty group(P>0.05).The compression ratio of anterior vertebral height and cobb kyphotic angle were significantly improved in two groups postoperatively and at final follow-up(P<0.05),and the recovery of injured vertebrae and the correction of cobb kyphotic angle in balloon group were significantl
作者
刘颖
张渝
文化
赵军
洪浩
丁浩洋
杨荣
Liu Ying;Zhang Yu;Wen Hua;Zhao Jun;Hong Hao;Ding Haoyang;Yang Rong(Department of Orthopaedic Surgery,Chongqing Orthopaedic Hospital of Traditional Chinese Medicine,Chongqing 400012,China)
出处
《创伤外科杂志》
2022年第9期681-688,共8页
Journal of Traumatic Surgery
基金
重庆市渝中区基础研究与前沿探索项目(20210141)。
关键词
骨质疏松性骨折
椎体成形术
椎体后凸成形术
临床疗效
osteoporotic vertebral compression fractures
vertebroplasty
kyphoplasty
clinical efficacy
