不同方式下骨水泥强化椎弓根螺钉固定手术治疗伴骨质疏松症腰椎退变性疾病的疗效对比

Comparison of effect of bone cement with pedicle screw fixation in the treatment of lumbar degenerative disease with osteoporosis under different methods

目的观察不同方式下骨水泥强化椎弓根螺钉固定手术治疗伴骨质疏松症腰椎退变性疾病的临床疗效。方法回顾性分析60例伴骨质疏松症腰椎退变性疾病患者的临床资料,根据固定方式分为观察组和对照组,每组30例,观察组采用新型可灌注椎弓根螺钉+PMMA骨水泥固定,对照组采用常规椎弓根螺钉+PMMA骨水泥固定。结果观察组手术时间显著短于对照组(P<0.05),两组患者末次随访Cobb角度、椎间隙高度、椎体变形指数、上椎板凹陷角度、下椎板凹陷角度较术前显著改善(P<0.05),且与对照组比较,观察组椎间隙高度、椎体变形指数等显著降低(P<0.05)。两组患者末次随访VAS评分、JOA评分和ODI评分较术前显著改善(P<0.05),且组间比较无显著性差异(P>0.05)。两组患者并发症发生率,差异不具有统计学意义(P>0.05)。结论新型可灌注椎弓根螺钉骨水泥强化固定治疗伴骨质疏松症腰椎退变性疾病疗效显著,且能够降低骨水泥渗漏及螺钉松动和断裂的风险。

Objective To observe the clinical effects of bone cement with pedicle screw fixation in the treatment of lumbar degenerative diseases with osteoporosis under different methods. Methods The clinical data of 60 patients with lumbar degenerative disease accompanied by osteoporosis were retrospectively analyzed. The patients were divided into the observation group and the control group according to the fixed way, with 30 patients in each group. The observation group was treated with new type of vertebral pedicle screw and PMMA bone cement fixation, while the control group was treated with conventional pedicle screw and PMMA bone cement fixation. Results The operation time in the observation group was significantly shorter than the control group （P〈0.05）, and the Cobb angle, inter-vertebral height, vertebral lamina deformation index and depression angle, the concave angles of upper or lower vertebral lamina at the time of the latest follow-up in the patients of two groups were significantly improved（P〈0.05）. And compared with the control group, the inter-vertebral height, vertebral deformation index in the observation group decreased significantly（P〈0.05）. The scores of VAS, JOA and ODI were significantly improved at the time of latest follow-up in the two groups compared with before operation（P〈0.05）, and there was no significant difference between the two groups（P〉0.05）. There was no significant difference in the incidence rate of complication between the two groups（P〉0.05）. Conclusions New type of pedicle screw fixation with bone cement for the treatment of lumbar degenerative disease with osteoporosis is effective and can reduce the risk of bone cement leakage and loosening and breakage of the screws.