摘要
目的探讨依据术前MRI信号特点指导穿刺在经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折中的应用效果。方法根据随机数字表法将40例单节段骨质疏松性椎体压缩骨折患者分为观察组(PVP治疗中依据术前MRI信号特点指导椎体穿刺,20例)和对照组(PVP治疗中采用常规穿刺椎体中部,20例)。记录两组骨水泥注入情况、疼痛VAS评分、伤椎Cobb角以及伤椎前缘高度比。结果患者均获得随访,时间6~12(7.5±3.2)个月。骨水泥注入量、骨水泥渗漏率两组比较差异均无统计学意义(P>0.05)。骨水泥弥散情况观察组优于对照组(P<0.05)。疼痛VAS评分:两组术后3 d、6个月均低于术前(P<0.05),术后3 d观察组低于对照组(P<0.05),术后6个月两组比较差异无统计学意义(P>0.05)。伤椎前缘高度比:两组术后6个月均低于术前及术后3 d(P<0.05),术后6个月观察组高于对照组(P<0.05)。伤椎Cobb角:两组术后6个月均小于术前及术后3 d(P<0.05),术后6个月观察组大于对照组(P<0.05)。结论在PVP治疗骨质疏松性椎体压缩骨折中,依据术前MRI信号特点指导穿刺位置,有利于骨水泥弥散、恢复伤椎前缘高度,疗效满意。
Objective To investigate the application effect of guiding puncture by MRI signal characteristic in the treatment of osteoporotic vertebral compression fracture(OVCF)treated with percutaneous vertebroplasty(PVP).Methods The 40 patients with single-level OVCFs were divided into observation group(in the PVP treatment of 20 cases,the puncture needle was guided according to the preoperative MRI signal characteristics)and control group(in the PVP treatment of 20 cases,the central part of the vertebra was routinely punctured),according to random number table method.Bone cement injection,pain VAS,Cobb angle of injured vertebra and the height ratio of anterior margin of the injured vertebra were recorded.Results All patients were followed up for 6~12(7.5±3.2)months.There were no statistical differences in bone cement injection volume and bone cement leakage rate between the two groups(P>0.05).The bone cement diffusion in observation group was better than that in control group(P<0.05).The pain VAS:at 3 d and 6 months after surgery,the scores of two groups were both lower than before surgery(P<0.05);at 3 d after surgery,the observation group was lower than that of control group(P<0.05),and there was no statistical difference between two groups at 6 months after surgery(P>0.05).The height ratio of anterior margin of the injured vertebra:at 6 months after surgery,the two groups were both lower than before surgery and 3 d after surgery(P<0.05),and the observation group was higher than the control group at 6 months after surgery(P<0.05).Cobb angles of injured vertebrae:at 6 months after surgery,two groups were smaller than those before surgery and 3 d after surgery(P<0.05),and the observation group was larger than the control group at 6 months after surgery(P<0.05).Conclusions In PVP treatment of OVCF,the use of MRI signal characteristics to guide the puncturing location is beneficial to the diffusion of bone cement and restoring the height of anterior margin of the injured vertebrae,with satisfactory efficacy.
作者
高炳俊
吴树华
GAO Bing-jun;WU Shu-hua(Dept of Orthopaedics,the People's Hospital of Danyang City Affiliated of Nantong University,Danyang,Jiangsu 212300,China)
出处
《临床骨科杂志》
2023年第6期770-773,共4页
Journal of Clinical Orthopaedics
