摘要
目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)时,椎体内裂隙对疗效是否有所影响。方法回顾性分析了2012-07-2015-07行PKP技术治疗的100例OVCF患者,其中术前存在椎体内裂隙者38例,为A组;无裂隙者62例,作为B组。对两组患者术后的VAS评分、ODI指数改善情况,伤椎矫正情况和骨水泥分布、渗漏情况进行对比。结果两组术后均获随访16-37个月,平均25.3个月。两组术后VAS评分、ODI指数均获得显著改善,伤椎前缘相对高度和后凸Cobb角均有良好矫正(P<0.05);组间对比,A组术后3 d的VAS评分、ODI指数改善情况差于B组(P<0.05),伤椎前缘高度和后凸Cobb角则优于B组(P<0.05),但末次随访期间,两组指标较为相近(P>0.05)。骨水泥在椎体内的分布情况:A组以团块型为主,B组则以海绵型和混合型为主,差异均有统计学意义(P<0.05)。A组骨水泥渗漏率为18.4%,以椎体周围渗漏为主;B组为16.1%,以椎间盘渗漏为主。两组的骨水泥渗漏率较为相近(P=0.667),但骨水泥渗漏类型则有较大差异(P<0.05)。结论无论OVCF患者的伤椎内是否存在裂隙,PKP技术均可获得良好疗效;但骨水泥在椎体内的分布和骨水泥渗漏类型有所不同,且伤椎内裂隙者术后可出现早期疼痛残留、伤椎复位有所丢失现象。
Objective To investigate the effect of percutaneous kyphoplasty （PKP） in thetreatment of osteoporotic vertebral compression fractures （OVCF）, and whether vertebral fissures haveeffect on the efficacy. Methods A retrospective analysis of 100 OVCF patients treated with PKP fromJuly 2012 to July 2015 was conducted. Among them, there were 38 cases of intra vertebral fractures,and they were selected as A group. There were 62 cases without fractures, and they were selected asgroup B. The VAS score, ODI index improvement, the correction of the injured vertebra and thedistribution and leakage of cement in the two groups were compared. Results Two groups of patientssuccessfully completed the operation. All patients were followed up for 16-37 months, with an averageof 25.3 months. The VAS score, ODI index after operation in the two groups were significantlyimproved, the anterior vertebral height and kyphosis Cobb angle had good correction （P 〈0.05）.Postoperative 3 days, the improvement of VAS score, ODI index in A group was worse than that in theB group （P〈0.05）, the anterior vertebral height and kyphosis Cobb angle in A group were better thanthose of B group （P〈0.05）, but at the end of the follow-up period, the indicators of two groups weresimilar （P〉0.05）. The distribution of bone cement in vertebral body： A group was mainly block type,while B group was mainly sponge type and mixed type, the difference was statistically significant （P〈0.05）. The bone cement leakage rate of A group was 18.4%, mainly around the vertebral leakage, thatof B group was 16.1%, mainly was the intervertebral disc leakage. The bone cement leakage rate ofthe two groups was similar （P=0.667）, but the type of bone cement leakage was significantly different（P 〈0.05）. Conclusion Whether there is a crack in the injured vertebra of OVCF patients, PKPtechnology can obtain good curative effect; but the distribution of bone cement in the vertebral bodyand the types of bone cement leakage are different, vertebral fracture and postoperative pain mayoccur early, residual vertebral body has lost phenomenon.
作者
关春辉
周占锋
GUAN Chun-hui;ZHOU Zhan-feng(Department of Orthopedics,the First People＇s Hospital of Zhengzhou,Zhengzhou,Henan 450000,China)
出处
《颈腰痛杂志》
2018年第6期702-705,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
经皮椎体后凸成形术
骨质疏松性椎体压缩骨折
椎体内裂隙征
疗效对比
percutaneous kyphoplasty
osteoporotic vertebral compression fractures
intravertebral fissure sign
comparison of efficacy
