摘要
目的 观察单球囊双侧序贯扩张联合高黏度水泥椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCFs)的效果及早中期随访情况。方法 2022年3月~2024年1月OVCFs病人120例,按手术治疗方式不同分为两组,对照组58例,采用高黏度水泥PVP治疗;观察组62例,采用单球囊双侧序贯扩张联合高黏度水泥PVP治疗。观察两组手术指标、疼痛程度视觉模拟评分(VAS)、椎体功能和早中期随访情况。结果 观察组的手术时间为(41.84±7.47)分钟,长于对照组的(36.17±6.51)分钟,骨水泥用量为(5.60±1.21) ml,多于对照组的(4.79±1.08) ml,骨水泥弥散系数为(3.48±0.36),高于对照组的(3.30±0.33),两组比较差异有统计学意义(P<0.05);两组术后3天的VAS评分低于术前,术后3个月的VAS评分低于术后3天,差异有统计学意义(P<0.05);术后3天,观察组椎体高度为(22.07±2.21) mm,大于对照组的(20.98±2.08) mm,后凸Cobb角为(10.76±1.22)°,小于对照组的(12.29±1.31)°,术后3个月,观察组Oswestry功能障碍指数(ODI)为(21.47±4.13)%,低于对照组的(23.12±4.25)%,差异有统计学意义(P<0.05)。术后3个月两组并发症发生情况相似(P > 0.05)。术后6个月观察组并发症发生率为3.23%,低于对照组的13.79%,两组比较差异有统计学意义(P<0.05)。结论 单球囊双侧序贯扩张联合高黏度骨水泥PVP治疗OVCFs可提高骨水泥注入量和弥散效果,减少疼痛,有利于椎体功能恢复,早中期随访中并发症发生风险较低。
Objective To observe the effect of percutaneous vertebroplasty(PVP)with single balloon bilateral sequential dilatation and high-viscosity cement in the treatment of osteoporotic vertebral compression fractures(OVCFs),and early to mid-term follow-up.Methods 120 patients with OVCFs were retrospectively selected from March 2022 to January 2024 in the hospital,and divided into control group(n=58,PVP with high-viscosity cement)and observation group(n=62,PVP with single balloon bilateral sequential dilatation and high-viscosity cement)according to different surgical methods.Surgical indicators,pain degrees,vertebral function,and early to mid-term follow-up results in both groups were observed.Results The operation time of the observation group was(41.84±7.47)minutes,which was longer than that of the control group(36.17±6.51)minutes.The amount of bone cement used was(5.60±1.21)ml,which was more than that of the control group(4.79±1.08)ml;the dispersion coefficient of bone cement was(3.48±0.36),which was higher than that of the control group[(3.30±0.33)],and the difference between the two groups was statistically significant(P<0.05).The Visual Analogue Scale(VAS)scores of both groups on day 3 after surgery were lower than those before surgery,and the VAS scores at 3 months after surgery were lower than those on day 3 after surgery(P<0.05).On day 3 after surgery,vertebral height of observation group was[(22.07±2.21)mm]greater than that of control group[(20.98±2.08)mm],and Cobb angle was[(10.76±1.22)°]smaller than that of control group[(12.29±1.31)°].Three months after surgery,Oswestry Disability Index(ODI)of observation group was[(21.47±4.13)%]lower than that of control group[(23.12±4.25)%](P<0.05).Early follow-up found that the incidence of complications in the two groups was comparable(P>0.05).Mid-term follow-up found that the incidence of complications was significantly lower in observation group(3.23%)than in the control group(13.79%)(P<0.05).Conclusion PVP with single balloon bilateral sequential dilatation and high-viscosity cement for OVCFs can improve the injection volume and diffusion effect of cement,reduce pain,and facilitate vertebral function recovery.Moreover,the risk of complications during early to mid-term follow-up is relatively low.
作者
钟立坚
朱权
黄少敏
ZHONG Lijian;ZHU Quan;HUANG Shaomin(Department of Orthopedics,the Third People's Hospital of Longgang District,Guangdong,Shenzhen 518115,China)
出处
《临床外科杂志》
2025年第11期1209-1213,共5页
Journal of Clinical Surgery
