老年性骨质疏松性椎体压缩骨折的精准骨水泥注入及临床疗效研究

Clinical study on precise bone cement injection and its distribution in senile osteoporotic vertebral compression fractures

目的探究老年性骨质疏松性椎体压缩骨折(OVCFs)的精准骨水泥注入与患者临床恢复情况。方法选取我院收治的胸12椎体上部、中部、下部骨折OVCFs各10例,对骨折患者分别实施不同剂量骨水泥(2ml、4ml、6ml)经皮球囊扩张椎体后凸成形术(PKP)治疗,并以参与研究患者的CT、MRI影像资料为基础,构建胸腰段(胸11-腰2)三维有限元模型进行力学检测,分析不同类型OVCFs的力学特点及不同类型OVCFs实行PVP治疗时的骨水泥剂量。结果患者术前、术后VAS评分分别为:椎体上缘组(8.00±0.47)分、(3.10±0.31)分;椎体中部组:(7.80±0.63)分、(3.40±0.51)分;椎体下组:(7.80±0.42)分、(3.20±0.63)分。患者术前、术后Cobb角分别为:椎体上缘组(11.80±1.22°)、(8.40±1.64°);椎体中部组(12.00±1.05°)、(8.70±1.05°);椎体下缘组:(11.70±1.16°)、(8.30±1.25°)。结论OVCFs患者经PVP治疗过程中,不同部位骨折骨水泥注入剂量差异较大,通过构建胸腰段三维有限元模型进行力学检测,不同发病部位给予不同剂量骨水泥填充,均可明显缓解患者疼痛(P<0.05,有统计学意义),恢复Cobb(P<0.05,有统计学意义)。

Objective To explore the precise bone cement injection and its distribution in senile osteoporotic vertebral compression fractures (OVCFs).Methods Each10 case of upper OVCFs、 middle OVCFs, and 10 case of lower OVCFs volunteers who admitted in our hospital were selected.Different doses of bone cement (2 ml, 4 ml, 6 ml) percutaneously kyphoplasty (PKP) was conducted on the patients with fracture.Based on the CT and MRI images of the patients involved in the study, a thoracolumbar (thoracic 11-lumbar 2) three-dimensional finite element model was constructed for mechanical test.The mechanical characteristics of different types of OVCFs were analyzed, and the dose of bone cements of different types of OVCFs treated with PVA were analyzed.Results The preoperative and postoperative VAS scores were (8 ± 0.47) and (3.10 ± 0.31) in the upper edge of the vertebral body, and (7.80 ± 0.63) and (3.40 ± 0.51) in the middle group of vertebral body, and (7.80 ± 0.42) and (3.20 ± 0.63) in the lower group of vertebral bodies.The Cobb angle before and after the operation were: the upper margin of the vertebral body (11.80 ± 1.22 °),(8.40 ± 1.64 °), the central group (12 ± 1.05 °) and (8.70 ± 1.05 °), and the lower edge group of the vertebral body (11.70 ± 1.16 °) and (8.30 ± 1.25°).Conclusion In the course of PVP treatment, the dosage of bone cement injection varies greatly in the different parts of the fracture of OVCFs.The three-dimensional finite element model of the thoracolumbar segment is used to carry out the mechanical test.The different doses of bone cement filling in different sites can obviously relieve the pain of the patients (P<0.05, statistically significant), and the recovery of Cobb (P<0.05, There is a statistical significance.