骨填充网袋治疗胸腰段椎体裂隙征

Treatment of thoracolumbar vertebral fissure sign with bone-filled mesh bag

目的研究骨填充网袋在胸腰段椎体裂隙征骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床运用效果。方法选择2016年1月~2017年8月本院收治的54例椎体裂隙征OVCF患者,按治疗方式进行分组,观察组采用骨填充网袋灌注骨水泥治疗,对照组采用经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗。比较两组手术相关指标,随访24个月以上,比较术前、术后1个月、末次随访时的VAS评分、椎体前缘高度比、Cobb角,记录术后并发症发生情况。结果观察组手术时间、术中透视次数显著低于对照组,差异有统计学意义(P<0.05);两组患者住院时间、随访时间、骨水泥注入量差异无统计学意义(P>0.05);两组术后1个月、末次随访时的椎体前缘高度比显著升高,VAS评分、Cobb角均显著降低,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05);观察组骨水泥渗漏率显著低于对照组,差异有统计学意义(P<0.05)。结论骨填充网袋灌注骨水泥治疗椎体裂隙征OVCF,能有效缓解疼痛症状,恢复椎体高度,较PKP手术的治疗时间更短、透视次数更少,还可降低骨水泥渗漏。

Objective To study the clinical effect of bone-filled mesh bags on osteoporotic vertebral compression fractures(OVCF)in thoracic and lumbar vertebral fissures.Methods Fifty-four patients with vertebral fissure OVCF admitted to our hospital from January 2016 to August 2017 were selected.They were divided two groups according to the treatment method.The observation group was treated with bone-filled mesh bag perfusion of bone cement,and the control group was treated with percutaneous kyphoplasty(PKP).The surgical related indicators of two groups were compared,and the patients were followed up for more than 24 months.The VAS score,anterior edge height ratio of vertebral body,Cobb angle before surgery,1 month after surgery,and at the last follow-up were compared.The occurrence of postoperative complications was recorded.Results The operation time and intraoperative perspective time of the observation group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in hospitalization time,follow-up time and bone cement injection volume(P>0.05).The height ratio of the anterior border of the vertebral body was significantly increased in two groups at 1 month after operation and the last follow-up,and the VAS score and Cobb angle were significantly decreased,the differences were statistically significant(P<0.05).However,there was no significant difference between the two groups(P>0.05).The leakage rate of bone cement in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Bone filling mesh bag perfusion of bone cement in the treatment of vertebral fissure OVCF can effectively relieve pain symptoms and restore vertebral height.Compared with PKP treatment,it has shorter treatment time,less fluoroscopy,and can reduce bone cement leakage.