骨水泥分布对单节段OVCF椎体后凸成形术临床疗效影响分析

Analysis of the Influence of Bone Cement Distribution on the ClinicalEfficacy of Single-segment OVCF Vertebral Kyphosis Plasty

分析比较骨水泥分布对单节段骨质疏松性椎体压缩性骨折(OVCF)椎体后凸成形术临床疗效的影响。收集2013年6月—2018年5月合肥市第三人民医院诊治的单节段胸腰椎骨质疏松性椎体压缩性骨折并行PKP手术患者120例(120个椎体),根据骨水泥分布将患者分为3组(团块状26例,混合状39例,海绵状55例),分析比较3组患者年龄、性别、骨密度T值、合并内科疾病、体重指数、受伤至手术时间、脊柱损伤节段和平均随访时间,分别于术前和术后24 h、3个月、6个月和1 a评估患者Oswestry功能障碍指数(ODI)、Cobb's角、伤椎前缘压缩率和疼痛视觉模拟量表评分(VAS)分值,并注意记录术后骨水泥渗漏和伤椎再骨折发生例数,分析比较2组患者手术前后及组间各项统计学差异。结果显示:术后3组患者在各时间点ODI、Cobb's角、伤椎前缘压缩率和VAS评分均较术前明显改善(P<0.05),但组间ODI、Cobb's角及VAS评分差异无统计学意义(P>0.05),术后团块状及混合状分布组伤椎前缘压缩率低于海绵状组(P<0.05),海绵状组伤椎再发骨折比例低于另外2组(P<0.05)。结果表明:不同骨水泥分布对ODI、Cobb's角和VAS评分影响较小,团块状及混合状分布恢复伤椎高度效果更佳,海绵状分布伤椎再发骨折几率更低。

This paper aims at analyzing and comparing the influence of bone cement distribution on the clinical efficacy of single-segment OVCF vertebral kyphosis plasty.By collecting a total of 120 cases(120 centrum)of patients with single-segment thoracolumbar vertebral osteoportic vertebral compression fracture,who have received PKP surgery at the Third People's Hospital in Hefei City from June 2013 to May 2018,and dividing them into 3 groups as per the distribution of bone cement(crumby 26,mixed 39,and spongy 55),the study compared and analyzed their age,sex,bone density T value,complicating internal medicine diseases,body mass index,injury-to-surgery time,spinal injury segment,and average follow-up time,evaluated their Oswestry disability index(ODI),Cobb's angle,injured centrum front edge compression rate and pain visual analogue scale(VAS)respectively within 24 h,3 months,6 months and 1 year before and after surgery,recorded the number of cases of bone cement leakage and injured centrum re-fracture after surgery,and analyzed and compared the statistical differences between three groups of patients as well as between preoperation and postoperation.The results show that the ODI,Cobb's angle,injured centrum front edge compression rate and VAS scores of three groups are significantly improved after surgery at all time nodes(P<0.05),but the differences in such terms between groups have no statistical meaning(P<0.05),and after surgery,the injured centrum front compression rate of the clumpy and mixed distribution group are lower than that of the spongy group(P<0.05),and the proportion of re-fracture in the spongy group is lower than that of the other 2 groups(P<0.05).The distribution of bone cement has minor effect on ODI,Cobb's angle and VAS score,while the clumpy and mixed distribution have better effect on restoring vertebral height,and spongy distribution has lower chance of re-fracture.