高黏度骨水泥经皮椎体成形术对骨质疏松性腰椎骨折的有效性及安全性系统评价

Systematic Evaluation of the Efficacy and Safety of High-viscosity Bone Cement Percutaneous Vertebroplasty for Osteoporotic Lumbar Fractures

目的探讨高黏度骨水泥经皮椎体成形术对骨质疏松性腰椎骨折的有效性及安全性。方法研究对象为方便选取92例骨质疏松性腰椎骨折患者,研究时间为2016年12月—2018年8月,按照抽签方法的不同分为两组,即对照组给予低黏度骨水泥注入,观察组给予高黏度骨水泥注入,且对治疗后VAS评分、ODI评分、JOA评分、影像学指标进行观察及评估。结果观察组治疗后15 d VAS评分(2.56±0.78)分、治疗后3个月VAS评分(1.02±0.41)分及治疗后1年VAS评分(1.03±0.43)分均低于对照组数据[治疗后15 d VAS评分(4.23±1.32)分、治疗后3个月VAS评分(2.30±0.70)分、治疗后1年VAS评分(1.32±0.67)分(t=7.39、10.71、2.47,P<0.05)。观察组治疗后6个月ODI评分(19.85±1.20)分及治疗后1年ODI评分(16.20±0.52分)低于对照组[治疗后6个月ODI评分(32.10±1.78)分、治疗后1年ODI评分(20.52±0.88)分](t=38.70、28.66,P=0.01,P<0.05),而治疗后6个月JOA评分(20.52±1.05)分、治疗后1年JOA评分(24.85±1.25)分高于对照组[治疗6个月JOA评分(17.52±0.90)分、治疗后1年JOA评分20.03±1.01)分(t=14.71、20.34,P=0.01,P<0.05)。观察组治疗后椎体高度压缩率(18.20±2.10)%、椎体后凸Cobb角(8.21±0.32)°低于对照组(椎体高度压缩率(23.32±2.52)%、椎体后凸Cobb角(15.52±0.56)°,(t=10.59、76.87,P=0.01,P<0.05);而椎体高度恢复率(47.52±4.85)%高于对照组(26.25±2.32)%(t=26.83,P=0.01,P<0.05)。结论高黏度骨水泥经皮椎体成形术治疗骨质疏松性腰椎骨折具有较高的临床价值,能够更好的恢复椎体高度及Cobb角,对改善预后具有明显促进作用。

Objective To investigate the efficacy and safety of high-viscosity bone cement percutaneous vertebroplasty for osteoporotic lumbar fractures.Methods A total of 92 patients with osteoporotic lumbar vertebrae fractures were enrolled.The study period was convenient from December 2016 to August 2018.They were divided into two groups according to the different drawing methods.The control group was given low-viscosity bone cement injection.High-viscosity bone cement was injected,and the VAS score,ODI score,JOA score,and imaging index were observed and evaluated after treatment.Results The VAS score(2.56±0.78)points at 15 days after treatment,the VAS score(1.02±0.41)points at 3 months after treatment,and the VAS score(1.03±0.43)points at 1 year after treatment were lower than the control data.The VAS score was 4.23±1.32)points on the 15 th day after treatment,the VAS score was(2.30±0.70)points in the 3 months after treatment,and the VAS score was(1.32±0.67)points in the 1 year after treatment(t=7.39,10.71,2.47,P<0.05).The ODI score(19.85±1.20)points and the 1-year ODI score(16.20±0.52)points after treatment were lower in the observation group than in the control group[ODI score(32.10±1.78)points after treatment,1 year after treatment ODI The score was(20.52±0.88)points](t=38.70,28.66,P=0.01),P<0.05,and the JOA score(20.52±1.05)points at 6 months after treatment and the JOA score(24.85±1.25)points after treatment were higher than 1 year after treatment.The control group[the JOA score of(17.52±0.90)points for 6 months and the JOA score of(20.03±1.01)points for 1 year after treatment](t=14.71,20.34,P=0.01,P<0.05).After treatment,the vertebral body height compression rate was(18.20±2.10)%,and the kyphosis Cobb angle 8.21±0.320 was lower than the control group(vertebral body height compression rate(23.32±2.52)%,vertebral kyphosis Cobb angle(15.52±0.56)°],(t=10.59,76.87,P=0.01,P<0.05);and the height recovery rate of vertebral body(47.52±4.85%)was higher than that of the control group(26.25±2.32)%(t=26.83,P=0.01,P<0.05).Conclusion High-viscosity bone cement percutaneous vertebroplasty for the treatment of osteoporotic lumbar fracture has high clinical value,can better restore vertebral height and Cobb angle,and has a significant effect on improving prognosis.