经皮弯角椎体成形术治疗胸腰椎骨质疏松性椎体压缩骨折的临床效果

Clinical effect of percutaneous curved vertebroplasty in the treatment of thoracolumbar osteoporotic vertebral compression fracture

目的 探析经皮弯角椎体成形术(PCVP)治疗胸腰椎骨质疏松性椎体压缩骨折(OVCF)的临床效果。方法 88例胸腰椎OVCF患者为研究对象,依据随机数字表法分为观察组和对照组,每组44例。观察组采用PCVP治疗,对照组采用经皮椎体成形术(PVP)治疗。比较两组患者的手术相关指标,疼痛及腰椎功能,治疗前后椎体前缘、后缘高度压缩率。结果 观察组的手术时间(21.83±3.28)min短于对照组的(38.16±4.26)min、X线曝光次数(8.97±1.75)次少于对照组的(17.52±1.58)次、骨水泥注入量(4.16±1.42)ml多于对照组的(3.28±1.15)ml、骨水泥分布理想率93.18%高于对照组的77.27%,差异具有统计学意义(P<0.05)。治疗后3个月,两组的视觉模拟评分法(VAS)、Oswestry功能障碍指数问卷表(ODI)评分均低于本组治疗前,差异具有统计学意义(P<0.05)。治疗后3个月,两组的椎体前缘、后缘高度压缩率均低于本组治疗前,差异具有统计学意义(P<0.05)。结论 PCVP治疗胸腰椎OVCF的临床效果显著,可在降低骨水泥渗漏风险的同时有效增加骨水泥注入量、改善骨水泥双侧分布情况。

Objective To discuss and analyze the clinical effect of percutaneous curved vertebroplasty(PCVP) in the treatment of thoracolumbar osteoporotic vertebral compression fracture(OVCF). Methods A total of 88 patients with thoracolumbar OVCF were selected as the research subjects, and were divided into observation group and control group according to the random numerical table, with 44 cases in each group. The observation group was treated with PCVP, and the control group was treated with percutaneous vertebroplasty(PVP). The surgical related indicators, pain and lumbar function, and the compression rate of anterior and posterior edge of vertebral body before and after treatment were compared between the two groups. Results In the observation group, the operation time(21.83±3.28) min was shorter than(38.16±4.26) min of the control group;the number of X-ray exposures(8.97±1.75) times was less than(17.52±1.58) times of the control group;the amount of bone cement injection(4.16±1.42) ml was more than(3.28±1.15) ml of the control group;the ideal rate of bone cement distribution 93.18% was higher than 77.27% of the control group;all the differences were statistically significant(P<0.05). 3 months after treatment, the visual analogue scale(VAS) and Oswestry disability index(ODI) scores of the two groups were lower than those of this group before treatment, and the difference was statistically significant(P<0.05). 3 months after treatment, the compression rate of anterior and posterior edge of vertebral body in the two groups were lower than those before treatment in this group, and the difference was statistically significant(P<0.05).Conclusion PCVP has significant clinical effect in the treatment of thoracolumbar OVCF, which can not only reduce the risk of bone cement leakage, but also effectively increase the amount of bone cement injection and improve the bilateral distribution of bone cement.