预防性骨水泥灌注强化对胸腰段骨质疏松性VCFs的疗效

Effect of Preventive Bone Cement Perfusion Reinforcement on Thoracolumbar Osteoporotic VCFs Patients

目的:探讨预防性骨水泥灌注强化对胸腰段骨质疏松性椎体压缩性骨折(VCFs)的疗效。方法:选取2021年9月-2023年1月昆山市第三人民医院收治的100例胸腰段骨质疏松性VCFs患者,随机分为对照组和观察组,各50例。对照组采用经皮椎体(或后凸)成形术(PVP/PKP)治疗,观察组在对照组基础上对相邻正常椎体进行预防性骨水泥灌注强化。比较两组术前、术后视觉模拟评分法(VAS)评分、伤椎高度、Cobb角、生活质量及随访过程中邻椎再骨折发生率。结果:术前,两组VAS评分、伤椎高度、Cobb角、生活质量量表(SF-36)评分比较,差异无统计学意义(P>0.05)。术后3个月、6个月,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);术后3个月、6个月,观察组伤椎高度高于对照组,Cobb角低于对照组,差异有统计学意义(P<0.05);术后3个月、6个月,观察组SF-36各项评分均高于对照组,差异有统计学意义(P<0.05)。观察组邻椎再骨折发生率为0,低于对照组的12.00%(6/50),差异有统计学意义(χ^(2)=4.433,P=0.035)。结论:预防性骨水泥灌注强化能有效改善胸腰段骨质疏松性VCFs患者椎体功能,在提升患者近远期生活质量的同时,还能降低远期临椎再骨折的发生率。

Objective:To investigate the effect of preventive bone cement perfusion reinforcement on thoracolumbar osteoporotic vertebral compression fractures(VCFs).Method:A total of 100 patients with thoracolumbar osteoporotic VCFs treated in the Third People's Hospital of Kunshan City from September 2021 to January 2023 were randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with percutaneous vertebroplasty(PVP)or percutaneous kyphoplasty(PKP),and the observation group was treated with preventive bone cement perfusion reinforcement to adjacent normal vertebroplasty on the basis of the control group.Preoperative and postoperative visual analogue scale(VAS)scores,injured vertebra height,Cobb Angle,quality of life and the incidence of refracture of adjacent vertebra during follow-up were compared between the two groups.Result:Before surgery,there were no significant differences in VAS score,injured vertebral height,Cobb angle and the MOS item short from health survey(SF-36)score between the two groups(P>0.05).At 3 months and 6 months after surgery,VAS scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At 3 months and 6 months after surgery,the height of injured vertebra in observation group were higher than those in control group,and the Cobb angle were lower than those in control group,the differences were statistically significant(P<0.05).At 3 months and 6 months after surgery,SF-36 scores in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of refracture of adjacent vertebra in the observation group was 0,which was lower than 12.00%(6/50)in the control group,and the difference was statistically significant(χ^(2)=4.433,P=0.035).Conclusion:Preventive bone cement perfusion reinforcement can effectively improve the vertebral function of patients with thoracolumbar osteoporotic VCFs,improve the quality of life of patients in the near and long term,and reduce the incidence of distant vertebral refracture.