不同骨水泥注入方案在老年胸腰段骨质疏松性椎体压缩性骨折患者中的应用

Application of different kinds of bone cement injection schemes in the treatment of elderly patients with single segment thoracolumbar OVCF

目的探讨偏侧、近中线及双侧骨水泥注入在老年胸腰段骨质疏松性椎体压缩性骨折患者中的应用效果差异。方法回顾性分析2016年1月~2019年6月收治单节段老年胸腰段骨质疏松性椎体压缩性骨折患者共90例临床资料,分别行偏侧、近中线或双侧骨水泥注入,每组各30例;比较三组手术前后腰背疼痛视觉模拟评分,骨水泥渗漏和再次注入情况。结果近中线组和双侧组术后1 d腰背疼痛视觉模拟评分均显著低于偏侧组(P<0.05);双侧组骨水泥渗漏发生率均显著低于偏侧组、近中线组(P<0.05);而偏侧组骨水泥再次注入比例则显著高于近中线组、双侧组(P<0.05)。结论近中线和双侧骨水泥注入用于老年胸腰段骨质疏松性椎体压缩性骨折治疗更有助于缓解早期疼痛,降低骨水泥渗漏和再次注入率,疗效优于偏侧骨水泥注入。

Objective To investigate the application effects differences of bone cement injection schemes by unilateral,near middle-line and bilateral in the treatment of elderly patients with single segment thoracolumbar OVCF.Methods 90 elderly patients with single segment thoracolumbar OVCF were chosen in the period from January 2016 to June 2019 and randomly divided into 3 groups including unilateral group(30 patients)with bone cement injection schemes by unilateral,near middle-line group(30 patients)with bone cement injection schemes by near middle-line and bilateral group(30 patients)with bone cement injection schemes by bilateral;and the pain VAS score before and after operation,intraoperative,bone cement leakage incidence and secondary cement injection rate of both groups were compared.Results The pain VAS score in 1d after operation of near middle-line group and bilateral group were significantly lower than unilateral group(P<0.05).The bone cement leakage incidence of bilateral group were significantly lower than unilateral group and near middle-line group(P<0.05).The secondary cement injection rate of unilateral group were significantly higher than near middle-line group and bilateral group(P<0.05).Conclusion Compared with bone cement injection schemes by unilateral,bone cement injection schemes by near middle-line and bilateral in the treatment of patients with single segment thoracolumbar OVCF can efficiently higher pain relief effects in early stage and prevent bone cement leakage and secondary cement injection risk.