[1]王红旗.骨水泥弥散状况对骨质疏松性胸腰椎椎体骨折经皮椎体后凸成形术效果的影响[J].新乡医学院学报,2019,36(11):1074-1077.[doi:10.7683/xxyxyxb.2019.11.016]
　WANG Hong-qi.Influence of bone cement dispersion on the effect of percutaneous kyphoplasty in the treatment of osteoporotic thoracolumbar vertebral fracture[J].Journal of Xinxiang Medical University,2019,36(11):1074-1077.[doi:10.7683/xxyxyxb.2019.11.016]
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骨水泥弥散状况对骨质疏松性胸腰椎椎体骨折经皮椎体后凸成形术效果的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年11
页码:
1074-1077
栏目:
临床研究
出版日期:
2019-11-05

文章信息/Info

Title:
Influence of bone cement dispersion on the effect of percutaneous kyphoplasty in the treatment of osteoporotic thoracolumbar vertebral fracture
作者:
王红旗
（商丘市第一人民医院骨一科，河南　商丘　476100）
Author(s):
WANG Hong-qi
(Department of Osteology，the First People′s Hospital of Shangqiu City，Shangqiu 476100,Henan Province,China)
关键词:
胸腰椎椎体骨折; 骨质疏松; 经皮椎体后凸成形术; 骨水泥弥散状况
Keywords:
thoracolumbar vertebral fractures; osteoporosis; percutaneous kyphoplasty; bone cement dispersion
分类号:
R681.5+3
DOI:
10.7683/xxyxyxb.2019.11.016
文献标志码:
A
摘要:
目的　探讨骨水泥弥散状况对骨质疏松性胸腰椎椎体骨折经皮椎体后凸成形术（PKP）效果的影响。方法　选择2015年1月至2017年12月商丘市第一人民医院收治的骨质疏松性胸腰椎椎体骨折患者132例为研究对象，所有患者接受PKP治疗，根据手术穿刺方式分为单侧骨水泥弥散组（n=80）和双侧骨水泥弥散组（n=52），单侧骨水泥弥散组患者采取左侧椎弓根入路，双侧骨水泥弥散组患者采取双侧椎弓根穿刺。分别于术前及术后1、12个月采用视觉模拟评分法（VAS）评估患者疼痛，采用X线片测量伤椎椎体前缘高度压缩率和伤椎矢状面Cobb角，并观察术后伤椎再骨折率及不良反应。结果　2组患者术前VAS评分比较差异无统计学意义（P>0.05）；2组患者术后1、12个月VAS评分显著低于术前（P<0.05），2组患者术后12个月VAS评分显著低于术后1个月（P<0.05）；术后1、12个月，双侧骨水泥弥散组患者VAS评分显著低于单侧骨水泥弥散组（P<0.05）。术前及术后1、12个月，2组患者伤椎前缘高度压缩率及伤椎矢状面Cobb角比较差异均无统计学意义（P>0.05）；2组患者术后1、12个月伤椎前缘高度压缩率及伤椎矢状面Cobb角显著小于术前（P<0.05），2组患者术后12个月与术后1个月伤椎前缘高度压缩率及伤椎矢状面Cobb角比较差异无统计学意义（P>0.05）。术后1 a内，单侧骨水泥弥散组患者伤椎再骨折7例（8.75%），非伤椎再骨折3例（3.75%）；双侧骨水泥弥散组患者伤椎再骨折0例（0.00%），非伤椎再骨折2例（3.85%）；双侧骨水泥弥散组患者伤椎再骨折率显著低于单侧骨水泥弥散组（χ2=4.768，P<0.05），2组患者非伤椎再骨折发生率比较差异无统计学意义（χ2=0.001，P>0.05）。单侧骨水泥弥散组和双侧骨水泥弥散组患者并发症发生率分别为3.75%（3/80）、1.92%（1/52），2组患者并发症发生率比较差异无统计学意义（χ2=0.366，P>0.05）。结论　PKP骨质疏松性胸腰椎椎体骨折中，单侧、双侧骨水泥弥散均可以有效恢复伤椎椎体前缘高度，但双侧骨水泥弥散可以更有效地缓解患者术后疼痛，降低伤椎再骨折率。
Abstract:
Objective　To investigate the influence of bone cement dispersion on the effect of percutaneous kyphoplasty(PKP) in the treatment of osteoporotic thoracolumbar vertebral fractures.Methods　A total of 132 patients with osteoporotic thoracolumbar vertebral fracture admitted to the First People′s Hospital of Shangqiu City from January 2015 to December 2017 were selected as the study objects.All patients were treated with PKP，and they were divided into unilateral bone cement diffusion group (n=80) and bilateral bone cement diffusion group (n=52) according to the puncture method.The patients in the unilateral bone cement diffusion group were performed with left pedicle approach，while the patients in the bilateral bone cement diffusion group were treated with bilateral pedicle approach.The pain of the patients was evaluated by visual analogue scales(VAS)，and the compression rate of the height of anterior vertebral edge and the sagittal Cobb angle of the injured vertebra were measured by X-ray film before and one，twelve months after operation.The rate of refracture and adverse reactions were observed.Results　There was no significant difference in VAS score between the two groups (P>0.05).The VAS score at one and twelve months after treatment was significantly lower than that before operation in the two groups (P<0.05).The VAS score at twelve months after operation was significantly lower than that at one month after operation in the two groups (P<0.05).The VAS score in the bilateral bone cement diffusion group was significantly lower than that in the unilateral bone cement diffusion group at one and twelve months after treatment(P<0.05).There was no significant difference in the compression rate of the height of anterior vertebral edge and the sagittal Cobb angle of the injured vertebra between the two groups before and one and twelve months after operation (P>0.05).The compression rate of the height of anterior vertebral edge and the sagittal Cobb angle of the injured vertebra at one and twelve months after operation were significantly less than those before operation(P<0.05).There was no significant difference in the height of anterior vertebral edge and the sagittal Cobb angle of the injured vertebra between the two groups at one and twelve months after operation (n=0.05).Within one year after operation，there were 7 cases (8.75%) of the injured vertebrae refracture and 3 cases (3.75%) of the non injured vertebrae refracture，there were 0 case (0.00%) the injured vertebrae refracture and 2 cases (3.85%) of the non injured vertebrae refracture.The refracture rate of the injured vertebrae in the bilateral bone cement diffusion group was significantly lower than that in the unilateral bone cement diffusion group (χ2=4.768，P<0.05).There was no significant difference in the refracture rate of non injured vertebrae between the two groups (χ2=0.001，P>0.05).The incidence of complications in the unilateral bone cement diffusion group and bilateral bone cement diffusion group was 3.75% (3/80) and 1.92% (1/52)，respectively.There was no significant difference in the incidence of complications between the two groups (χ2=0.366，P>0.05).Conclusion　The unilateral and bilateral bone cement diffusion can effectively restore the anterior edge height of the injured vertebral body in PKP for osteoporotic thoracolumbar vertebral fracture，but the bilateral bone cement diffusion can more effectively alleviate the postoperative pain and reduce the rate of refracture of the injured vertebral body.

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更新日期/Last Update: 2019-11-05