网袋椎体成形术治疗伴椎体裂隙征的骨质疏松性椎体压缩骨折

Effect of mesh bag vertebroplasty in the treatment of osteoporotic vertebral compression fractures with vertebral body fissure sign

目的探讨网袋椎体成形术治疗伴椎体内裂隙征的骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)临床疗效。方法自2015年9月-2016年12月,共纳入OVCF患者62例,经CT检查均伴有椎体内裂隙征。依据手术方案的不同分为两组:观察组31例,均予以网袋椎体成形术治疗;对照组31例,均予以PKP手术治疗。对两组患者的骨水泥渗漏情况、手术疗效和伤椎矫正度进行比较。结果(1)骨水泥渗漏:观察组2例发生骨水泥渗漏,发生率为6.45%;对照组发生6例,发生率为19.35%。观察组的渗漏率显著低于对照组(x2=7.405;P=0.007)。(2)疗效观察:两组术后3 d和1年时,VAS评分和ODI指数均显著降低(P<0.05);组间比较,两组术前、术后3 d和1年的两项指标差异均无统计学意义(P>0.05)。(3)伤椎矫正度:两组术后3 d和1年时,伤椎后凸Cobb角与椎体前缘相对高度均获得良好矫正(P<0.05);组间比较,两组术前、术后3 d和1年的两项指标差异均无统计学意义(P>0.05)。结论网袋椎体成形术治疗伴有椎体内裂隙征的OVCF患者,其疗效与传统PKP手术相近,但显著降低了骨水泥渗漏率。

Objective To explore the clinical effect of mesh bag vertebroplasty in the treatment of osteoporotic vertebral compression fractures(OVCF)with vertebral body fissure sign.Methods From September 2015 to December 2016,a total of 62 patients with OVCF were included,and vertebral body fissure sign was confirmed by CT examination.According to the different surgical procedures,they were divided into two groups:31 cases in the observation group were treated with mesh bag vertebroplasty,and 31 cases in the control group were treated with percutaneous kyphoplasty(PKP)operation.The bone cement leakage,surgical effect and degree of correction were compared between the two groups.Results(1)Bone cement leakage:2 cases had bone cement leakage in the observation group,the incidence rate was 6.45%,and 6 cases in the control group,the incidence rate was 19.35%.The leakage rate of the observation group was significantly lower than that of the control group(x 2=7.405;P=0.007).(2)Curative effect:the VAS score and ODI index in two groups decreased significantly at 3 days and 1 year after operation,and the differences were statistically significant compared with before operation(P<0.05),and there were no significant differences between the two groups in VAS score and ODI index before operation and at 3 days and 1 year after operation(P>0.05).(3)The correction of vertebral injury:the vertebral posterior convex Cobb angle and the relative height of the anterior edge of the vertebral body were well corrected in two groups at 3 days and 1 year after operation(P<0.05).There were no statistically significant differences between the two groups in the above two indicators before operation and at 3 days and 1 year after operation(P>0.05).Conclusion The effect of mesh bag vertebroplasty in the treatment of OVCF patients with vertebral body fissure sign is similar to traditional PKP operation,but it can significantly reduce the leakage rate of bone cement and has certain clinical advantages.