摘要
[目的]探讨经皮椎体成形术(percutaneous vertebroplasty, PVP)治疗重度骨质疏松性椎体压缩骨折(severe osteoporosis vertebral compression fractures, sOVCF)的临床效果。[方法]回顾性分析2018年9月—2020年12月本院采用PVP治疗的39例sOVCF患者。评估临床和影像学资料。[结果]所有患者均顺利完成手术,平均手术时间(56.3±5.7) min,平均骨水泥注入量(5.2±2.2) ml。术中有9例发生骨水泥渗漏(23.1%),其中椎旁渗漏3例,椎间隙渗漏6例,均无明显临床症状。所有患者均获随访,随访时间平均(12.7±3.8)个月,随时间推移(术前、术后第2 d和末次随访时),VAS评分[(6.5±0.2)分,(2.4±0.8)分,(2.5±0.8)分, P<0.05]、ODI指数[(77.9±4.4)%,(24.2±2.9)%,(24.7±3.4)%, P<0.05]显著降低,而JOA评分[(14.3±2.7)分,(21.3±1.9)分,(20.7±1.7)分, P<0.05]显著增加。影像方面,伤椎高度[(6.7±1.7) mm,(16.5±4.0) mm,(14.4±3.3) mm, P<0.05]显著增加,而局部后凸Cobb角[(24.1±13.0)°,(15.6±10.2)°,(19.0±11.5)°, P<0.05]显著降低。[结论] PVP治疗sOVCF安全有效,术前体位复位和充分填充伤椎裂隙是治疗成功的关键。
[Objective] To investigate the clinical outcomes of percutaneous vertebroplasty(PVP) for severe osteoporotic vertebral compression fractures(sOVCF). [Methods] A retrospective study was conducted on 39 patients who received PVP for sOVCF in our hospital from September 2018 to December 2020. The clinical and radiological data were evaluated. [Results] All patients were successfully operated on with the mean operation time of(56.3±5.7) min and the mean bone cement injected of(5.2±2.2) ml. Bone cement leakage occurred in9 cases(23.1%), including paravertebral leakage in 3 cases and intervertebral leakage in 6 cases, all of which had no obvious clinical symptoms. All the patients were followed up for a mean of(12.7±3.8) months. With time elapsed preoperatively, 2 days postoperatively and the latest follow up, the VAS score [(6.5±0.2),(2.4±0.8),(2.5±0.8), P<0.05] and ODI score [(77.9±4.4),(24.2±2.9),(24.7±3.4), P<0.05]significantly reduced, while the JOA score [(14.3±2.7),(21.3±1.9),(20.7±1.7), P<0.05] significantly increased. Radiographically, the injured vertebral height [(6.7±1.7) mm,(16.5±4.0) mm,(14.4±3.3) mm, P<0.05] increased significantly, while the local kyphotic Cobb angle[(24.1±13.0)°,(15.6±10.2)°,(19.0±1.5)°, P<0.05] decreased significantly. [Conclusion] The PVP is safe and effective in the treatment of sOVCF. Preoperative position reduction and full filling of injured vertebral fissure are the key to successful treatment.
作者
张锋
田家宇
李多华
冯虎
孙伟
ZHANG Feng;TIAN Jia-yu;LI Duo-hua;FENG Hu;SUN Wei(Xuzhou Medical Uniersity,Xuzhou 221004,China;Department of Orthopedics,Afiliated Hospital,Xuzhou Medical University,Xuzhou 221006,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第6期567-570,共4页
Orthopedic Journal of China
基金
徐州市科技项目(编号:KC21210)
徐州市医学青年后备人才培养项目(编号:XWRCHT20220038)。
