椎体成形术中不同骨水泥注入量的临床疗效观察

Observation on the Clinical Curative Effect of Different Bone Cement Volume in Vertebroplasty

目的对比分析胸腰段椎体压缩性骨折椎体成形术(PVP)中不同骨水泥注入量的临床疗效。方法对2013年1月至2015年7月我院103例胸腰段单椎体压缩性骨折患者术前随机分为两组。椎体体积计量组53例,根据影像学检查模拟计算病锥骨折前体积,手术注入椎体体积的13%骨水泥;对照组50例,术者根据临床经验注入骨水泥,尽可能避免渗漏,增加骨水泥注入量。两组患者术前一般资料比较差异均无统计学意义(P>0.05)。比较骨水泥注入量、术后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分改善及并发症发生情况。结果对103例胸腰段椎体压缩性骨折患者行椎体成形术并追踪随访12 m。术中两组间骨水泥注入量差异有统计学意义(P<0.05);两组患者术后2 d和12 m VAS评分、ODI评分均较术前明显改善,与术前比较差异均有统计学意义(P<0.05);术后2 d两组间VAS评分、ODI评分差异均无统计学意义(P>0.05);术后12个月两组间VAS评分、ODI评分差异有统计学意义(P<0.05),椎体计量组明显优于对照组;两组间手术并发症发生率比较差异有统计学意义(P<0.05),椎体测量组小于对照组。结论根据影像学检查测量值计算病锥骨折前体积,决定手术注入骨水泥剂量,可以明显提高长期临床疗效,减少手术并发症。

Objective To investigate the clinical efficacy of the different bone cement volume calculated by computer in the treatment of the Single thoracolumbar fracture.Methods From January 2013 to July 2015,103 cases of thoracic lumbar vertebral compression fractures patients were randomly divided into two groups before operation.The vertebral body volume metering group of53 cases,according to the imaging simulation disease before cone fracture volume,13% of the injection volume of vertebral body bone cement operation.The control group of 50 cases of experience,performer according to the clinical experience in the injection of bone cement,as far as possible to avoid leakage Increased bone cement injection two groups of patients with preoperative general data comparison differences had no statistical significance（P〈0.05）,and to compare Bone cement volume、Postoperative pain visual analogue scale（VAS）、Oswestry disability index（ODI）score improvement and complications.Results 103 cases of thoracic lumbar vertebral compression fractures in patients with vertebral plasty and follow-up of 12 months bone cement injection to compare differences between the two groups was statistically significant（P〈0.05）;Two groups of patients with postoperative VAS score and ODI scores were obviously improved compared with preoperative in 2 days and 12 months,it had statistical significance（P〈0.05）;Postoperative VAS score and ODI score in 2 days between the two groups had no statistical significance（P〈0.05）;The two groups comparison difference on VAS score and ODI score in 12 months was statistically significant（P 0.05）,vertebral body measurement group experience is obviously better than the control group;Surgical complications compared differences between the two groups was statistically significant（P〈0.05）,vertebral body measurement group is less than the control group.Conclusion Determine the bone cement fill according to the imaging examination measurements the volume of vertebral body before fracture can obviously increase the long-term clinical curative effect and reduce the surgical complications.