两种骨水泥注入器在经皮椎体成形术中治疗骨质疏松性椎体压缩性骨折的临床比较

Clinical comparison of two different injectors in the percutaneous vertebroplasty treatment of osteoporotic vertebral compression fractures

目的探讨两种骨水泥注入器在经皮椎体成形术(PVP)中治疗骨质疏松性椎体压缩性骨折的临床效果。方法回顾性分析2019年1月—2020年3月在广东省阳江市人民医院脊柱骨科住院并行PVP的骨质疏松性椎体压缩性骨折的168例患者。按照PVP中骨水泥注入器的不同分为观察组(84例)和对照组(84例),观察组采用侧孔骨水泥注入器,对照组采用传统前开口骨水泥注入器,比较两组手术前后视觉模拟评分法(VAS)评分,术后骨水泥沿骨折线分布率、骨水泥渗漏率、伤椎塌陷/骨折发生率和邻椎骨折发生率。结果两组患者术前VAS评分比较,差异无统计学意义(P>0.05);两组患者术后第1天VAS评分比较,差异无统计学意义(P>0.05)。观察组和对照组术后的VAS评分低于本组术前,差异有统计学意义(P<0.05)。观察组的骨水泥沿骨折线分布率高于对照组,差异有统计学意义(P<0.05)。观察组的骨水泥渗漏率、伤椎塌陷/骨折发生率和邻椎骨折发生率低于对照组,差异有统计学意义(P<0.05)。结论在PVP中,使用侧孔骨水泥注入器和传统骨水泥注入器治疗骨质疏松性椎体压缩性骨折,两者均能取得较好的临床疗效,但使用侧孔骨水泥注入器手术的患者,骨水泥沿骨折线分布率更高,骨水泥渗漏率、伤椎塌陷/骨折发生率和邻椎骨折发生率更低,值得临床推广。

Objective To investigate the clinical effect of two different injectors in the percutaneous vertebroplasty(PVP)treatment of osteoporotic vertebral compression fractures.Methods Clinical data of 168 patients with osteoporosis vertebral compression fracture with PVP were analyzed retrospectively from January 2019 to March 2020 in the Department of Spinal Orthopedics,Yangjiang People's Hospital,Guangdong Province.They were divided into observation group(84 cases)and control group(84 cases)according to the different of bone cement injector in PVP.The observation group was treated with side hole bone cement injector,while patients in the control group were treated with traditional anterior opening bone cement injector.The visual analogue scale(VAS)score before and after operation,the distribution rate of bone cement along bone fracture line,the leakage rate of bone cement,the incidence of vertebral collapse/fracture and the incidence of adjacent vertebral fracture were compared between the two groups.Results There was no significant difference in preoperative VAS score between the two groups(P>0.05).There was no significant difference in VAS score between the two groups on the first day after operation(P>0.05).The VAS score of the observation group and the control group after operation was lower than that before operation,and the difference was statistically significant(P<0.05).The distribution rate of bone cement along fracture line in the observation group was higher than that in the control group,the difference was significant(P<0.05).The incidence rates of vertebral collapse/fracture and adjacent vertebral fracture in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion In PVP,the use of side hole bone cement injector and traditional bone cement injector in the treatment of osteoporotic vertebral compression fractures,both can achieve good clinical efficacy,but the use of side hole bone cement injector surgery patients,bone cement along the broken line distribution rate is higher,bone cement leakage rate,vertebral collapse/fracture rate and adjacent vertebral fracture rate is lower,it is worthy of clinical promotion.