腰椎定量CT对老年骨质疏松性腰椎压缩性骨折行PVP治疗的指导价值

The Guiding Value of Quantitative Lumbar Spine CT in the Treatment of Elderly Osteoporotic Lumbar Vertebral Compression Fractures with PVP

目的:评价椎体定量CT检测对老年骨质疏松性腰椎压缩性骨折患者行经皮穿刺椎体成形术(percutaneous vertebro plasty,PVP)的指导价值,以期为腰椎压缩性骨折选择正确穿刺入路方法提供理论依据。方法:选取2019年7月至2021年12月在我院骨科接受手术治疗的60岁以上骨质疏松性腰椎压缩性骨折患者172例,根据患者术前腰椎定量CT值不同,将患者分为轻度骨质疏松组(n=32)、中度骨质疏松组(n=84)、重度骨质疏松组(n=56)。比较轻度、中度、重度骨质疏松组的椎体穿刺情况和3组患者的骨水泥渗漏和骨水泥在椎体内弥散情况。结果:轻度、中度与重度骨质疏松组分别有行单侧入路椎体成形术患者9、76、52例,有双侧入路椎体成形术患者23、8、4例,3组单侧、双侧入路患者比例(χ^(2)=65.474,P<0.001)比较差异有统计学意义。轻度、中度与重度骨质疏松组分别有0例患者0个椎体、6例患者8个椎体、4例患者6个椎体发生渗漏,3组骨水泥渗漏的患者数(χ^(2)=2.437,P=0.298)和椎体数(χ^(2)=5.322,P=0.070)比较差异没有统计学意义。结论:以腰椎定量CT检测为指导选择单侧或双侧入路经皮穿刺椎体成形术,有助于提高手术的安全性,降低X线透视检测次数,缩短手术时间。

Objective:To evaluate the guiding value of vertebral quantitative CT detection in elderly patients with osteoporotic lumbar vertebral compression fractures undergoing percutaneous vertebro plasty(PVP),in order to select the correct puncture for lumbar vertebral compression fractures.The road method provides a theoretical basis.Methods:A total of 172 patients with osteoporotic lumbar vertebral compression fractures over 60 years old who received surgical treatment in the Orthopaedic Department of our hospital from July 2019 to December 2021 were selected.According to the different preoperative quantitative CT values of the lumbar spine,the patients were divided into mild Severe osteoporosis group(n=32),moderate osteoporosis group(n=84),and severe osteoporosis group(n=56).The vertebral puncture of the mild,moderate and severe osteoporosis groups and the bone cement leakage and the diffusion of bone cement in the vertebral body of the three groups were compared.Results:In mild,moderate and severe osteoporosis groups,9,76,and 52 patients underwent unilateral vertebroplasty,23,8,and 4 patients underwent bilateral vertebroplasty,and 3 There was a statistically significant difference in the proportion of patients with unilateral and bilateral approaches(χ^(2)=65.474,P<0.001).In mild,moderate and severe osteoporosis groups,there were 0 vertebral bodies in 0 patients,8 vertebral bodies in 6 patients,and 6 vertebral bodies in 4 patients,respectively.The number of patients with bone cement leakage in 3 groups(There was no significant difference inχ^(2)=2.437,P=0.298)and the number of vertebral bodies(χ^(2)=5.322,P=0.070).Conclusion:The selection of unilateral or bilateral percutaneous vertebroplasty with quantitative CT detection of the lumbar spine as a guide is helpful to improve the safety of the operation,reduce the number of X-ray fluoroscopy examinations,and shorten the operation time.