经皮椎体后凸成形术中使用不同剂量骨水泥对老年骨质疏松性压缩性骨折术后恢复的影响

Effect of Different Doses of Bone Cement during Percutaneous Kyphoplasty on Postoperative Recovery of Elderly Os­teoporotic Compression Fractures

目的:探究经皮椎体后凸成形术中使用不同剂量骨水泥对老年骨质疏松性压缩性骨折术后恢复的影响。方法:选择2018年2月—2020年2月在济源市中医院收治的66例老年骨质疏松性压缩性骨折患者作为研究对象,根据患者手术中使用骨水泥剂量的不同随机分为A组(常规剂量:2.5~5mL)、B组(低剂量:1~2.5mL)和C组(高剂量:5~7.5 mL),每组均为22例。观察三组手术前后椎体前缘高度、椎体后凸Cobb角及Oswerstry功能障碍指数(ODI)评分,观察三组手术后患者并发症发生情况。结果:手术前1d,三组的椎体前缘高度、椎体后凸Cobb角及ODI评分对比,差异无统计学意义(F=0.061、0.007、0.019,P>0.05)。手术后3d,三组的椎体后凸Cobb角及ODI评分均比手术前1d低、椎体前缘高度均比手术前1d高,且A组的椎体后凸Cobb角、ODI评分和椎体前缘高度均比B组和C组低。A组治疗后的渗漏率比B组和C组均低差异有统计学意义(F=3.263、3.619、3.660,χ^(2)=7.03,P<0.05)。结论:经皮椎体后凸成形术中使用小剂量骨水泥治疗老年骨质疏松性压缩性骨折患者,可明显改善患者的椎体前缘高度、椎体后凸Cobb角以及患者功能障碍,并且其渗漏率较低,故鼓励临床上在皮椎体后凸成形术中多使用小剂量的骨水泥。

Objective: To explore the effect of using different dosages of bone cement in percutaneous kyphoplasty on the postoperative recovery of elderly osteoporotic compression fractures. Methods: A total of 66 elderly patients with osteoporotic compression fractures who were admitted to the hospital from February 2018 to February 2020 were selected as the research objects. According to the different doses of bone cement used during surgery, they were randomly divided into group A(conventional dose:2.5-5 mL), group B(low dose: 1-2.5 mL) and group C(high dose: 5-7.5 mL), with 22 cases in each group. The height of the anterior edge of the vertebral body, the Cobb angle of kyphosis, and the Oswerstry dysfunction index(ODI) scores were observed before and after the operation in the 3 groups, and the complications of the 3 groups after the operation were observed. Results: There was no statistically significant difference in the height of the anterior edge of the vertebral body, the Cobb angle of the kyphosis,and the ODI score of the three groups 1 d before the operation(F=0.061, 0.007, 0.019, P>0.05). 3 d after the operation, the kyphotic Cobb angle and ODI scores of the three groups were lower than those of 1 d before the operation, and the height of the anterior edge of the vertebral body was higher than that of 1 d before the operation. And the Cobb angle, ODI score and anterior height of the vertebral body in group A were lower than those in group B and C. The leakage rate of group A after treatment was lower than that of group B and group C, the difference was statistically significant(F=3.263, 3.619, 3.660, χ^(2)=7.03, P<0.05). Conclusion: The use of low-dose bone cement to treat elderly patients with osteoporotic compression fractures during percutaneous kyphoplasty can significantly improve the height of the anterior edge of the vertebral body, the Cobb angle of the kyphosis, and the patients’ dysfunction. And its leakage rate is low, so it is encouraged to use more small doses of bone cement in the skin kyphoplasty.