脊柱-骨盆矢状位参数与椎体压缩骨折预后的相关性
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摘要
目的探讨脊柱-骨盆矢状位参数与椎体压缩骨折预后的相关性。方法 2013年3月至2018年3月,选择诊治的骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)患者258例,所有患者都给予经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗,记录所有患者的预后,测量脊柱-骨盆矢状位参数变化情况并进行相关性分析。结果所有患者都顺利完成手术,无术中术后严重并发症发生;手术时间为(67.20±10.33)min,术中出血量为(20.1±6.92)mL,术后住院时间为(6.20±0.67)d。术后1个月、术后3个月患者的Cobb角与Beck指数与术前1 d对比差异有统计学意义(P<0.05),术后3个月的总有效率为94.2%。术后3个月患者PT、PI、LL值都显著低于术前1 d(P<0.05)。Pearson相关分析显示患者的PT、PI、LL变化值与Cobb角、Beck指数、总有效率都有显著相关性(P<0.05)。结论经皮椎体成形术治疗骨质疏松性椎体压缩骨折具有很好的应用有效性与安全性,手术前后脊柱-骨盆矢状位参数变化与患者预后有显著相关性。
Objective To investigate the correlation between the spine-pelvic sagittal parameters and the prognosis of vertebral compression fractures. Methods From March 2013 to March 2018, 258 patients with osteoporotic vertebral compression fractures(OVCF) were selected and treated in our hospital. All patients were given percutaneous vertebroplasty(PVP) treatment, the prognosis of the two groups were recorded. The changes of the spine-pelvic sagittal parameters were measured and given correlation analysis. Results All patients were underwent successfully operation without major complications during operation. The operation time were(67.20±10.33)min, the intraoperative blood loss were(20.1±6.92)mL, and the postoperative hospital stay were(6.20±0.67)d. There were statistically significant difference in the Cobb angle and the Beck index compared between the 1 month postoperatively and 3 months after surgery(P<0.05). The total effective rate at 3 months after surgery were 94.2%. The PT, PI and LL values of patients at 3 months after operation were significantly lower than those before surgery(P<0.05). Pearson correlation analysis showed that patients' PT, PI, LL changes were significantly correlated with Cobb angle, Beck index, and total effective rates(P<0.05). Conclusion Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures has good application and safety. The changes of the spine-pelvic sagittal parameters before and after surgery are significantly correlated with the prognosis of patients.
Objective To investigate the correlation between the spine-pelvic sagittal parameters and the prognosis of vertebral compression fractures. Methods From March 2013 to March 2018, 258 patients with osteoporotic vertebral compression fractures(OVCF) were selected and treated in our hospital. All patients were given percutaneous vertebroplasty(PVP) treatment, the prognosis of the two groups were recorded. The changes of the spine-pelvic sagittal parameters were measured and given correlation analysis. Results All patients were underwent successfully operation without major complications during operation. The operation time were(67.20±10.33)min, the intraoperative blood loss were(20.1±6.92)mL, and the postoperative hospital stay were(6.20±0.67)d. There were statistically significant difference in the Cobb angle and the Beck index compared between the 1 month postoperatively and 3 months after surgery(P<0.05). The total effective rate at 3 months after surgery were 94.2%. The PT, PI and LL values of patients at 3 months after operation were significantly lower than those before surgery(P<0.05). Pearson correlation analysis showed that patients' PT, PI, LL changes were significantly correlated with Cobb angle, Beck index, and total effective rates(P<0.05). Conclusion Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures has good application and safety. The changes of the spine-pelvic sagittal parameters before and after surgery are significantly correlated with the prognosis of patients.
引文
[1] 雷鸣,戴海,黄宗贵.椎体成形术治疗合并椎体内裂隙征的压缩骨折疗效分析[J].实用骨科杂志,2018,24(1):57-60.
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[6] 郑永浩,刘保健,李元贞,等.椎体后凸成形术治疗骨质疏松性椎体压缩骨折[J].中国老年学杂志,2018,38(1):236-239.
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[8] 赵洪宇,钟磊,刘贺,等.X线上骨盆倾斜评估方法研究进展[J].中国实验诊断学,2017,21(3):546-549.
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[11] Ikuta K,Masuda K,Tominaga F,et al.Clinical and radiological study focused on relief of low back pain after decompression surgery in selected patients with lumbar spinal stenosis associated with grade i degenerative spondylolisthesis[J].Spine (Phila Pa 1976),2016,41(24):E1434-E1443.
[12] 张义龙,任磊,孙志杰,等.椎体成形术后新发椎体骨折与脊柱矢状位参数的相关性分析[J].重庆医学,2017,46(4):483-485.
[13] 赖宪良,陈鸥,苏嘉,等.双侧经皮椎体成形术中骨水泥注入量对压缩性颈椎骨折的影响[J].中国现代医学杂志,2018,28(5):68-72.
[14] Park JH,Ju CI,Kim SW.Posterior screw fixation in previously augmented vertebrae with bone cement:is it inapplicable?[J].J Korean Neurosurg Soc,2018,61(1):114-119.
[15] Capozzi A,Scambia G,Pedicelli A,et al.Clinical management of osteoporotic vertebral fracture treated with percutaneous vertebroplasty[J].Clin Cases Miner Bone Metab,2017,14(2):161-166.
[16] Mansour A,Abdel-razeq N,Abuali H,et al.Cement pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients[J].Cancer Imaging,2018,18(1):5-14.
[17] 俞阳,唐六一,范海泉.远程注射推进装置辅助PKP治疗老年骨质疏松性胸腰椎骨折的疗效分析[J].重庆医学,2018,47(3):403-405,415.
[18] Li H,Yang DL,Ma L,et al.Risk factors associated with adjacent vertebral compression fracture following percutaneous vertebroplasty after menopause:a retrospective study[J].Med Sci Monit,2017,5(23):5271-5276.
[19] 李庚午,杨长伟,陈凯,等.腰椎间盘退变与脊柱骨盆矢状面参数的相关性[J].中国临床医学,2017,24(2):194-198.
[20] 刘刚,马云婷.甘肃平凉地区中老年骨质疏松症的流行病学调查分析[J].国外医学(医学地理分册),2017,38(2):133-135.
[21] 杨惠林,李茂,孟斌.骨质疏松性椎体骨折骨不连诊断和治疗的相关问题[J].中华创伤杂志,2018,34(2):97-99.
[22] Ye LQ,Liang,Jiang XB,et al.Risk factors for the occurrence of insufficient cement distribution in the fractured area after percutaneous vertebroplasty in osteoporotic vertebral compression fractures[J].Pain Physician,2018,21(1):E33-E42.
[23] Shin EK,Kim CH,Chung CK,et al.Sagittal imbalance in patients with lumbar spinal stenosis and outcomes after simple decompression surgery[J].Spine J,2017,17(2):175-182.
[24] Zhang F,Zhang K,Tian HJ,et al.Correlation between lumbar intervertebral disc height and lumbar spine sagittal alignment among asymptomatic Asian young adults[J].J Orthop Surg Res,2018,13(1):34-38.
[2] Kaliya-perumal AK,Lin TY.Clinical outcomes of percutaneous vertebroplasty for selective single segment dorsolumbar vertebral compression fractures[J].J Clin Orthop Trauma,2018,9(Suppl 1):S140-S144.
[3] Koné N,Freitas olim E,Coloma P,et al.A continuous series of 27 adult patients treated for L5-S1 isthmic spondylolisthesis by combined approach:Clinical and radiological outcomes at 1 year follow-up[J].Neurochirurgie,2017,63(2):74-80.
[4] 陈军.椎体后凸成形术治疗骨质疏松性脊柱骨折的临床效果观察[J].中国基层医药,2018,25(3):291-294.
[5] Wang Y,Zhong H,Zhou Z,et al.Letter to the editor regarding “Analysis of risk factors for secondary new vertebral compression fracture following percutaneous vertebroplasty in patients with osteoporosis”[J].World Neurosurg,2017,7(103):924-925.
[6] 郑永浩,刘保健,李元贞,等.椎体后凸成形术治疗骨质疏松性椎体压缩骨折[J].中国老年学杂志,2018,38(1):236-239.
[7] Radovanovic I,Urquhart JC,Ganapathy V,et al.Influence of postoperative sagittal balance and spinopelvic parameters on the outcome of patients surgically treated for degenerative lumbar spondylolisthesis[J].J Neurosurg Spine,2017,26(4):448-453.
[8] 赵洪宇,钟磊,刘贺,等.X线上骨盆倾斜评估方法研究进展[J].中国实验诊断学,2017,21(3):546-549.
[9] Wang T ,Wang H ,Liu H ,et al.Sagittal spinopelvic parameters in 2-level lumbar degenerative spondylolisthesis:a retrospective study[J].Medicine,2016,95(50):e5417-e5419.
[10] 彭鹏,陈亚萍.老年人脊柱骨盆参数数字化测量及临床意义[J].中国老年学杂志,2017,37(8):1999-2000.
[11] Ikuta K,Masuda K,Tominaga F,et al.Clinical and radiological study focused on relief of low back pain after decompression surgery in selected patients with lumbar spinal stenosis associated with grade i degenerative spondylolisthesis[J].Spine (Phila Pa 1976),2016,41(24):E1434-E1443.
[12] 张义龙,任磊,孙志杰,等.椎体成形术后新发椎体骨折与脊柱矢状位参数的相关性分析[J].重庆医学,2017,46(4):483-485.
[13] 赖宪良,陈鸥,苏嘉,等.双侧经皮椎体成形术中骨水泥注入量对压缩性颈椎骨折的影响[J].中国现代医学杂志,2018,28(5):68-72.
[14] Park JH,Ju CI,Kim SW.Posterior screw fixation in previously augmented vertebrae with bone cement:is it inapplicable?[J].J Korean Neurosurg Soc,2018,61(1):114-119.
[15] Capozzi A,Scambia G,Pedicelli A,et al.Clinical management of osteoporotic vertebral fracture treated with percutaneous vertebroplasty[J].Clin Cases Miner Bone Metab,2017,14(2):161-166.
[16] Mansour A,Abdel-razeq N,Abuali H,et al.Cement pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients[J].Cancer Imaging,2018,18(1):5-14.
[17] 俞阳,唐六一,范海泉.远程注射推进装置辅助PKP治疗老年骨质疏松性胸腰椎骨折的疗效分析[J].重庆医学,2018,47(3):403-405,415.
[18] Li H,Yang DL,Ma L,et al.Risk factors associated with adjacent vertebral compression fracture following percutaneous vertebroplasty after menopause:a retrospective study[J].Med Sci Monit,2017,5(23):5271-5276.
[19] 李庚午,杨长伟,陈凯,等.腰椎间盘退变与脊柱骨盆矢状面参数的相关性[J].中国临床医学,2017,24(2):194-198.
[20] 刘刚,马云婷.甘肃平凉地区中老年骨质疏松症的流行病学调查分析[J].国外医学(医学地理分册),2017,38(2):133-135.
[21] 杨惠林,李茂,孟斌.骨质疏松性椎体骨折骨不连诊断和治疗的相关问题[J].中华创伤杂志,2018,34(2):97-99.
[22] Ye LQ,Liang,Jiang XB,et al.Risk factors for the occurrence of insufficient cement distribution in the fractured area after percutaneous vertebroplasty in osteoporotic vertebral compression fractures[J].Pain Physician,2018,21(1):E33-E42.
[23] Shin EK,Kim CH,Chung CK,et al.Sagittal imbalance in patients with lumbar spinal stenosis and outcomes after simple decompression surgery[J].Spine J,2017,17(2):175-182.
[24] Zhang F,Zhang K,Tian HJ,et al.Correlation between lumbar intervertebral disc height and lumbar spine sagittal alignment among asymptomatic Asian young adults[J].J Orthop Surg Res,2018,13(1):34-38.
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