椎体成形骨水泥分期注射技术治疗骨质疏松性椎体爆裂骨折的临床探讨

Clinical Study on the Treatment of Osteoporotic Vertebral Burst Fracture by Stage Injection of Vertebral Body Cement

目的 椎体成形骨水泥分期注射技术治疗骨质疏松性椎体爆裂骨折的临床疗效和安全性。方法 分析2013年7月-2018年12月嘉峪关市第一人民医院收治的86例骨质疏松性椎体爆裂骨折患者的临床资料;按照治疗方法分为骨水泥分期治疗PVP组和椎体成形骨水泥分期注射技术治疗骨质疏松性椎体爆裂骨折PKP组(经皮椎体后凸成形术)及对比治疗PKP、PVP组。比较治疗情况。结果 治疗前患者椎体前缘、椎体后缘、后凸Cobb、椎管占位对比,无显著差异(P>0.05);治疗后PKP分期注射组椎体前缘、椎体后缘、椎管占位均显著高于PVP分期注射组,后凸Cobb角显著低于PVP分期注射组,两组术后各项指标对比均改善,PKP组改善方面明显优于PVP组(P <0.05),治疗后PKP分期注射组与PVP分期注射组总有效率对比,无显著差异(P>0.05);PKP分期注射组、PVP分期注射组与PKP组、PVP组对比,存在统计学意义(P <0.05)。结论 采用椎体成形骨水泥分期注射技术治疗椎管占位<25%且无脊髓神经症状的骨质疏松性椎体爆裂骨折安全可行,骨水泥分期注射技术可明显减少骨水泥外渗,是一种安全有效的治疗技术。

Objective To evaluate the clinical efficacy and safety of vertebroplasty and cement injection in the treatment of osteoporotic vertebral burst fractures. Methods To analyze the clinical data of 86 patients with osteoporotic vertebral burst fracture treated in our hospital from July 2013 to December 2018. According to the treatment methods, they were divided into two groups: PVP group treated with staged bone cement, PKP group treated with staged injection of vertebroplasty bone cement(percutaneous kyphoplasty) and PKP and PVP group. Compare treatment. Results Before treatment, there was no significant difference in the anterior edge of vertebral body, posterior edge of vertebral body, kyphosis Cobb and spinal canal occupancy(P > 0.05). After treatment, the anterior edge of vertebral body, posterior edge of vertebral body and spinal canal occupation of PKP injection group were significantly higher than those of PVP injection group, and the Cobb angle of kyphosis was significantly lower than that of PVP injection group. All indexes of the two groups were improved after operation, and the improvement of PKP injection group was significantly better than that of PVP group(P < 0.05). There was no significant difference in the total effective rate between PKP injection group and PVP injection group after treatment(P > 0.05). Compared with PKP group and PVP group, PKP group and PVP group had statistical significance(P < 0.05). Conclusion It is safe and feasible to treat osteoporotic vertebral burst fracture with vertebral canal occupying less than 25% and without neurological symptoms by staged injection of bone cement. Staged injection of bone cement can significantly reduce the extravasation of bone cement, which is a safe and effective treatment technology.