摘要
目的探讨改良分次骨水泥推注在骨质疏松性腰椎压缩性骨折改良经皮椎体成形术中的应用效果。方法选取2020年3月至2022年3月该院收治的66例骨质疏松性腰椎压缩性骨折患者为研究对象。根据治疗方法的不同,将患者分为对照组(32例)与研究组(34例)。所有患者均行经皮椎体成形术,其中对照组采取传统骨水泥注射治疗,研究组采取改良分次骨水泥推注治疗。对比2组手术耗时、骨水泥推注量及渗漏率。观察2组不同时间点的疼痛情况[视觉模拟评分法(VAS)]、伤椎椎体前缘高度、后凸Cobb角及Oswestry功能障碍指数(ODI)评分。结果研究组手术耗时、骨水泥推注量与对照组比较,差异均无统计学意义(P>0.05)。研究组骨水泥渗漏率低于对照组(P<0.05)。VAS评分、ODI评分均存在时间效应及交互效应(P<0.05);与术前相比,术后3 d、末次随访时的VAS评分、ODI评分均降低(P<0.05),且末次随访时的VAS评分、ODI评分均较术后3 d降低(P<0.05);2组间VAS评分、ODI评分比较,差异均无统计学意义(P>0.05)。伤椎椎体前缘高度和后凸Cobb角均存在时间效应及交互效应(P<0.05);与术前相比,术后3 d、末次随访时伤椎椎体前缘高度均升高(P<0.05),后凸Cobb角均减小(P<0.05);但末次随访时的伤椎椎体前缘高度、后凸Cobb角与术后3 d比较,差异均无统计学意义(P>0.05);2组间伤椎椎体前缘高度、后凸Cobb角比较,差异均无统计学意义(P>0.05)。结论骨质疏松性腰椎压缩性骨折应用改良分次骨水泥推注,能够减轻疼痛与肢体功能障碍、恢复椎体高度及降低Cobb角,且未延长手术时间及增加骨水泥注入量,可大幅度减少骨水泥渗漏的发生。
Objective To investigate the effect of modified fractional bone cement injection in modified percutaneous vertebroplasty for osteoporotic lumbar compression fracture.Methods Sixty-six patients with osteoporotic lumbar compression fractures treated in this hospital from March 2020 to March 2022 were selected as the study subjects and divided into the control group(32 cases)and study group(34 cases)according to different treatment methods.All patients underwent percutaneous vertebroplasty.The control group adopted the traditional bone cement injection,and the study group was treated with modified fractional bone cement injection.The operation time,bone cement injection amount and leakage rate were compared between the two groups.The pain situation[visual analogue scale(VAS)],height of the anterior edge of the injured vertebral body,the convex Cobb angle and the Oswestry dysfunction index(ODI)score at different time points in the two groups were observed.Results There was no statistically significant difference in the operation time and bone cement injection volume between the study group and control group(P>0.05).The bone cement leakage rate of the study group was lower than that of the control group(P<0.05).There was an interaction between the groups and time in the VAS score and ODI score(P<0.05).The VAS score and ODI score on 3 d after operation and at the last follow-up were significantly decreased compared with those before operation(P<0.05),moreover the VAS score and ODI score at the last follow-up were significantly decreased compared those on 3 d after operation(P<0.05).There were no statistically significant difference in VAS score and ODI score between the two groups(P>0.05).There was an interaction between the groups and time for the height of the anterior edge of the injured vertebrae and the Cobb angle of kyphosis(P<0.05).Compared with before operation,the anterior margin height of the injured vertebrae on 3 d after surgery and at the last follow-up was increased(P<0.05),and the kyphotic Cobb angle was
作者
占新华
孙健
宋旺胜
张国桥
林耀发
ZHAN Xinhua;SUN Jian;SONG Wangsheng;ZHANG Guoqiao;LIN Yaofa(Department of Orthopedics,Jiading Branch Hospital of Shanghai Municipal First People′s Hospital/Jiangqiao Hospital of Jiading District,Shanghai 201833,China)
出处
《检验医学与临床》
CAS
2023年第18期2682-2685,2692,共5页
Laboratory Medicine and Clinic
基金
上海市嘉定区自然科学研究课题(JDKW-2020-0039)。
关键词
改良分次骨水泥推注
骨质疏松症
腰椎压缩性骨折
经皮椎体成形术
骨水泥渗漏
modified graded bone cement injection
osteoporosis
lumbar vertebral compression fractures
percutaneous vertebroplasty
leakage of bone cement
