经皮椎体后凸成形注射骨水泥:快速缓解多节段胸腰椎骨质疏松性骨折的疼痛

Percutaneous kyphoplasty with bone cement injection rapidly eases pain in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures

背景:经皮椎体后凸成形注射骨水泥修复多节段胸腰椎体骨质疏松性骨折可恢复压缩椎体的高度,纠正畸形,减少并发症的发生。目的:验证经皮椎体后凸成形注射骨水泥修复多节段胸腰椎体骨质疏松性骨折的效果。方法:纳入T11-L4多节段胸腰椎体骨质疏松性骨折患者80例,其中男29例,女51例,年龄61-78岁,2节段椎体骨折者52例,3节段椎体骨折者22例,4节段椎体骨折者6例。随机均分为2组治疗,对照组给予积极的基础病与抗骨质疏松治疗,并卧床休息;试验组在此基础上给予经皮椎体后凸成形注射骨水泥治疗。治疗后随访12个月,对比两组Oswesty功能障碍指数、Barthel指数、目测类比评分、伤椎前缘及中线高度、Cobb角情况。结果与结论:试验组治疗后3 d、3个月、12个月的Oswesty功能障碍指数、Barthel指数、目测类比评分、伤椎前缘及中线高度、Cobb角均较治疗前明显改善(P<0.05);对照组治疗后3,12个月的Oswesty功能障碍指数、Barthel指数、目测类比评分均较治疗前明显改善(P<0.05),治疗后12个月的伤椎前缘及中线高度均较治疗前明显改善(P<0.05);治疗12个月后,试验组Oswesty功能障碍指数、Cobb角改善优于对照组(P<0.05),其余指标比较差异无显著性意义。试验组未发生与骨水泥材料相关的不良反应。表明经皮椎体后凸成形注射骨水泥可快速缓解多节段胸腰椎体骨疏松性骨折患者的疼痛,有效矫正后凸畸形,提高患者生活质量。

BACKGROUND： Peroutaneous kyphoplasty with bone cement injection for repair of multi-segmental thoracolumbar vertebral osteoporotic fractures can restore the compressed vertebral height, correct deformity and reduce complications. OBJECTIVE： To explore the therapeutic effects of percutaneous kyphoplasty with bone cement in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures. METHODS： Eighty patients with multi-segmental thorecolumbar vertebral osteoporotic fractures were enrolled, 29 males and 51 females, aged 61-78 year, including 52 case of two-segmental vertebral fractures, 22 cases of three-segmental vertebral fractures, 6 cases of four-segmental vertebral fractures. All the patients were divided into experimental group and control group randomly. Patients in the control group were given active basic treatment and anti-osteoporosis treatment and stayed in bed. Patients in the experimental group were given percutaneous kyphoplasty with bone cement injection on the above basis. All the patients were followed-up 12 months after treatment. Then the Oswesty dysfunction index, Barthel index, visual analog scale score, and theanterior vertebral height and midline height, Cobb angle were compared between the two groups. RESULTS AND CONCLUSION： In the experimental group, the Oswesty dysfunction index, Barthel index, visual analog scale score, and the anterior vertebral height and midline height, Cobb angle were all significantly improved at 3 days, 3 months and 12 months after treatment than before （P 〈 0.05）. In the contro~ group, the Oswesty dysfunction index, Barthel index and visual analog scale score were improved significantly at 3 and 12 months after treatment （P 〈 0.05）, while the anterior vertebral height and midline height were improve dramatically at 12 months after treatment （P 〈 0.05）. Compared with the control group, the experimental group showed better the Oswesty dysfunction index and Cobb angle than the control group at 12 months after treatment （P 〈 0.05）, but there were no difference in the other indicators between the two groups. No adverse reactions associated with bone cement material occurred in the experimental group Taken together, the percutaneous kyphoplasty with bone cement injection can rapidly relieve pain in patients with multi-segmental thorecolumbar vertebral osteoporotic fractures, which can correct kyphosis and improve patient＇s quality of life.