高粘度骨水泥经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折的疗效分析
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摘要
目的研究高粘度骨水泥经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折临床效果。方法选取2013-09-2016-12期间我院诊治的84例骨质疏松性胸腰椎压缩骨折患者作为研究对象,根据术式不同分为对照组42例、研究组42例。对照组患者接受低粘度骨水泥椎体后凸成形术治疗,研究组患者接受高粘度骨水泥经皮椎体成形术治疗。比较两组患者手术时间、骨水泥用量及手术前后疼痛程度、椎体高度变化、并发症发生率。结果研究组患者手术透视时间、单侧穿刺椎体骨水泥用量、双侧穿刺椎体骨水泥用量均低于对照组,差异有统计学意义(P<0.05);术后两组患者疼痛VAS评分均低于术前,椎体高度均高于术前,差异有统计学意义(P<0.05);但术后两组患者疼痛VAS评分、椎体高度比较,差异无统计学意义(P>0.05);两组患者术后并发症比较,差异无统计学意义(P>0.05)。结论高粘度骨水泥经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折效果与低粘度骨水泥椎体后凸成形术相似,术后并发症少,均能有效减轻疼痛,促进椎体高度恢复;但高粘度骨水泥经皮椎体成形手术透视时间短,骨水泥用量少,费用低廉,值得临床推广。
Objective To study the clinical effect of percutaneous vertebroplasty with high viscosity bone cement in the treatment of osteoporotic thoracic and lumbar vertebra compression fractures. Methods From September 2013 to December 2016, 84 patients with osteoporotic thoracic and lumbar vertebrae compression fractures were enrolled in our hospital. They were divided into control group(42 cases) and study group(42 cases) according to different surgical procedures. The patients in the control group received low viscosity bone cement kyphoplasty, and the patients in the study group were treated with high viscosity bone cement percutaneous vertebroplasty. The operation time, the amount of bone cement and the degree of pain, the height of vertebral body and the incidence of complication were compared between the two groups. Results The amount of bone cement used in the study group was lower than that in the control group,the difference was statistically significant(P<0.05). The VAS score of the two groups was lower than preoperation, and postoperative vertebral height was higher than before operation, the differences were statistically significant(P<0.05). However, there were no significant differences in VAS score and vertebral height between the two groups(P>0.05). There were no significant differences in the incidence rates of bone cement leakage, acute cerebral infarction, cerebrospinal fluid leakage and stress ulcer between the two groups(P>0.05). Conclusion High-viscosity bone cement percutaneous vertebroplasty and low viscosity bone cement kyphoplasty in the treatment of osteoporotic thoracolumbar spine compression fractures has similar effect, and with less postoperative complications, can effectively reduce the pain and promote vertebral height recovery. But high-viscosity bone cement percutaneous vertebroplasty surgery has advantages of short time, less bone cement, it is worthy of clinical promotion.
Objective To study the clinical effect of percutaneous vertebroplasty with high viscosity bone cement in the treatment of osteoporotic thoracic and lumbar vertebra compression fractures. Methods From September 2013 to December 2016, 84 patients with osteoporotic thoracic and lumbar vertebrae compression fractures were enrolled in our hospital. They were divided into control group(42 cases) and study group(42 cases) according to different surgical procedures. The patients in the control group received low viscosity bone cement kyphoplasty, and the patients in the study group were treated with high viscosity bone cement percutaneous vertebroplasty. The operation time, the amount of bone cement and the degree of pain, the height of vertebral body and the incidence of complication were compared between the two groups. Results The amount of bone cement used in the study group was lower than that in the control group,the difference was statistically significant(P<0.05). The VAS score of the two groups was lower than preoperation, and postoperative vertebral height was higher than before operation, the differences were statistically significant(P<0.05). However, there were no significant differences in VAS score and vertebral height between the two groups(P>0.05). There were no significant differences in the incidence rates of bone cement leakage, acute cerebral infarction, cerebrospinal fluid leakage and stress ulcer between the two groups(P>0.05). Conclusion High-viscosity bone cement percutaneous vertebroplasty and low viscosity bone cement kyphoplasty in the treatment of osteoporotic thoracolumbar spine compression fractures has similar effect, and with less postoperative complications, can effectively reduce the pain and promote vertebral height recovery. But high-viscosity bone cement percutaneous vertebroplasty surgery has advantages of short time, less bone cement, it is worthy of clinical promotion.
引文
[1]龙欣,戴民,张彪,等.经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的疗效分析[J].重庆医学,2014,43(20):2686-2688.
[2]刘纪恩,曹珺,勾瑞恩,等.经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折[J].中华创伤杂志,2015,31(05):423-426.
[3] Kang MS,Shin YH,Lee CD. Delayed neurological deficits induced by an epidural hematoma associated with a thoracic osteoporotic compression fracture[J]. Neurol Med Chir(Tokyo),2012,52(09):633-636.
[4]徐建成,白靖平,锡林宝勒日,等.注入骨水泥椎体成形与非手术治疗骨质疏松性椎体压缩骨折的Meta分析[J].中国组织工程研究与临床康复,2011,15(13):2366-2370.
[5]黎肇光.不同形态的骨水泥行椎体成形术治疗骨质疏松性胸腰椎压缩骨折的临床观察[J].颈腰痛杂志,2016,37(06):479-481.
[6]钟远鸣,程俊,仇振茂,等.单双侧经椎弓根入路PVP治疗骨质疏松性椎体压缩性骨折的Meta分析[J].中国矫形外科杂志,2014,22(10):892-897.
[7] Rotter R,Schmitt L,Gierer P, et al. Minimum cement volume required in vertebral body augmentation-A biomechanical study comparing thepermanent Spine Jack device and balloon kyphoplasty intraumaticfracture[J]. Clinical Biomechanics, 2015, 30(07):720-725.
[8]丁惠宇,夏建龙. PVP、PKP治疗胸腰椎骨质疏松性压缩骨折的疗效评价标准研究进展[J].山东医药,2014,54(14):101-103.
[9]郑召民,李佛保.经皮椎体成形术和经皮椎体后凸成形术—问题与对策[J].中华医学杂志,2006,86(27):1878-1800.
[2]刘纪恩,曹珺,勾瑞恩,等.经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折[J].中华创伤杂志,2015,31(05):423-426.
[3] Kang MS,Shin YH,Lee CD. Delayed neurological deficits induced by an epidural hematoma associated with a thoracic osteoporotic compression fracture[J]. Neurol Med Chir(Tokyo),2012,52(09):633-636.
[4]徐建成,白靖平,锡林宝勒日,等.注入骨水泥椎体成形与非手术治疗骨质疏松性椎体压缩骨折的Meta分析[J].中国组织工程研究与临床康复,2011,15(13):2366-2370.
[5]黎肇光.不同形态的骨水泥行椎体成形术治疗骨质疏松性胸腰椎压缩骨折的临床观察[J].颈腰痛杂志,2016,37(06):479-481.
[6]钟远鸣,程俊,仇振茂,等.单双侧经椎弓根入路PVP治疗骨质疏松性椎体压缩性骨折的Meta分析[J].中国矫形外科杂志,2014,22(10):892-897.
[7] Rotter R,Schmitt L,Gierer P, et al. Minimum cement volume required in vertebral body augmentation-A biomechanical study comparing thepermanent Spine Jack device and balloon kyphoplasty intraumaticfracture[J]. Clinical Biomechanics, 2015, 30(07):720-725.
[8]丁惠宇,夏建龙. PVP、PKP治疗胸腰椎骨质疏松性压缩骨折的疗效评价标准研究进展[J].山东医药,2014,54(14):101-103.
[9]郑召民,李佛保.经皮椎体成形术和经皮椎体后凸成形术—问题与对策[J].中华医学杂志,2006,86(27):1878-1800.