摘要
目的探究单侧椎弓根旁入路经皮椎体成形术(percutaneousvertebroplasty,PVP)对骨质疏松性椎体压缩骨折患者骨密度、椎体骨髓脂肪含量和椎体功能的影响。方法回顾性分析2019年1月至2022年5月宜春新建医院收治的80例骨质疏松性椎体压缩骨折患者的临床资料,根据入路方式不同分为单侧组(n=43,65椎)和双侧组(n=37,49椎)。两组均接受PVP治疗,单侧组采取单侧椎弓根旁入路PVP治疗,双侧组采用双侧椎弓根旁入路PVP治疗。比较两组围手术期指标(手术时间、骨水泥灌注量、骨水泥分布情况、X线暴露时间、住院时间)、并发症发生率、椎体恢复情况(Cobb角、前缘高度压缩比)、术后疼痛程度[视觉模拟评分法(visual analogue scale,VAS)]、椎体骨密度、椎体骨髓脂肪含量和椎体功能[Oswestry功能障碍指数(Oswestrydysfunctionindex,ODI)评分]。结果单侧组手术时间、X线暴露时间均短于双侧组,骨水泥灌注量少于双侧组,差异有统计学意义(P<0.05);两组骨水泥分布情况、住院时间、并发症发生率比较差异无统计学意义;术后7d、术后3个月,两组Cobb角均小于前一时间点,骨密度T值、骨髓脂肪含量、ODI评分均低于前一时间点,前缘高度压缩比均高于术前,而术后3个月前缘高度压缩比低于术后7d,差异有统计学意义(P<0.05);两组术前及术后各时间点Cobb角、前缘高度压缩比、骨密度T值、骨髓脂肪含量、ODI评分比较差异均无统计学意义。术后1d、7d、3个月,两组VAS评分均低于前一时间点,差异有统计学意义(P<0.05);两组术前及术后各时间点VAS评分比较差异均无统计学意义。结论单侧椎弓根旁入路PVP治疗骨质疏松性椎体压缩骨折与双侧椎弓根旁入路PVP治疗效果相似,可明显改善患者骨密度指标、椎体功能,减轻患者疼痛,还可缩短手术时间、X线暴露时间,减少骨水泥灌注量、椎体骨髓脂肪含量,且安全性较高。
Objective To investigate the influence of unilateral parapedicular approach percutaneous vertebroplasty(PVP)on bone mineral density,vertebral bone marrow fat content and vertebral function in patients with osteoporotic vertebral compression fractures.Methods The clinical data of 80 patients with osteoporotic vertebral compression fractures admitted to Yichun New Hospital from January 2019 to May 2022 were retrospectively analyzed,they were divided into the unilateral group(n=43,65 vertebrae)and the bilateral group(n=37,49 vertebrae)according to the different approaches.Both groups were treated with PVP,the unilateral group was treated with unilateral parapedicular approach PVP,while the bilateral group was treated with bilateral parapedicular approach PVP.The perioperative indexes(operation time,bone cement perfusionvolume,bone cement distribution,X-ray exposure time,hospitalization time),incidence rates of complications,vertebral recovery(Cobb angle,anterior height compression ratio),postoperative pain degree(visual analogue scale[VAS]),vertebral bone mineral density,vertebral bone marrow fat content and vertebral function(Oswestry dysfunction index[ODI]score)were compared between the two groups.Results The operation time and X-ray exposure time in the unilateral group were shorter than those in the bilateral group,and the bone cement perfusion volume was less than that in the bilateral group,the differences were statistically significant(P<0.05);there were no statistical differences in bone cement distribution,hospitalization time and incidence of complications between the two groups.At 7 d and 3 months after operation,the Cobb angle of the two groups was smaller than that at the previous time point,the T value of bone mineral density,bone marrow fat content and ODI score were lower than those at the previous time point,and the anterior height compression ratio was higher than that before surgery,and the anterior height compression ratio at 3 months after surgery was lower than that at 7 d after operation,the d
作者
刘学兵
晏细妹
严帅
LIU Xuebing;YAN Ximei;YAN Shuai(Department of Orthopedics,Yichun New Hospital,Yichun,Jiangxi,336000,China;Department of Surgery,Yichun New Hospital,Yichun,Jiangxi,336000,China)
出处
《当代医学》
2024年第17期65-70,共6页
Contemporary Medicine
关键词
单侧椎弓根旁入路经皮椎体成形术
骨质疏松性椎体压缩骨折
骨密度
椎体骨髓脂肪含量
椎体功能
Unilateral parapedicular approach percutaneous vertebroplasty
Osteoporotic vertebral compression fractures
Bone mineral density
Vertebralbone marrow fat content
Vertebral function
