单侧椎弓根旁入路BFMCs椎体成形术治疗骨质疏松性胸腰椎压缩骨折的效果

Effect of Unilateral Pedicle Approach BFMCs Vertebroplasty in the Treatment of Osteoporotic Thoracolumbar Compression Fractures

目的:探讨单侧椎弓根旁入路骨填充网袋(BFMCs)椎体成形术治疗骨质疏松性胸腰椎压缩骨折的效果。方法:将中国人民解放军联勤保障部队第九〇〇医院仓山院区2019年7月-2021年7月收治的76例骨质疏松性胸腰椎压缩骨折患者按照随机数字表法分为网袋组和球囊组,各38例。球囊组予以单侧椎弓根入路经皮球囊扩张椎体后凸成形术(PKP),网袋组予以单侧椎弓根旁入路BFMCs椎体成形术,观察两组手术情况、腰椎恢复情况及再骨折发生率。结果:网袋组骨水泥注入量少于球囊组,骨水泥充盈度优秀率(84.21%)高于球囊组(60.53%),骨水泥渗漏率(2.63%)低于球囊组(21.05%),差异均有统计学意义(P<0.05);术后3 d及6个月,两组视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)评分、伤椎Cobb角较术前降低,伤椎前缘高度较术前升高(P<0.05),但组间比较差异无统计学意义(P>0.05);网袋组再骨折发生率(13.16%)低于球囊组(34.21%),差异有统计学意义(P<0.05)。结论:单侧椎弓根旁入路BFMCs椎体成形术可缓解骨质疏松性胸腰椎压缩骨折患者疼痛,恢复并维持伤椎高度,矫正伤椎畸形,有助于减少骨水泥注入量,提高骨水泥充盈度优秀率,降低骨水泥渗漏率,减少再骨折发生率。

Objective:To explore the effects of unilateral pedicle approach bone filling mesh container(BFMCs)vertebroplasty to treat osteoporosis thoracolumbar compression fracture.Method:A total of 76 cases of osteoporotic thoracolumbar compression fractures patients who were treated in Cangshan Hospital of the 900th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army from July 2019 to July 2021 were divided into mesh bag group and ball pockets group according to the random number table method,38 cases in each group.The ball pockets group performed unilateral pedicle approach percutaneous kyphoplasty(PKP),and the mesh bag group performed unilateral pedicle approach BFMCs vertebroplasty.The operation,recovery of lumbar vertebrae and incidence of re-fracture were observed.Result:The amount of bone cement injection in the mesh bag group was less than that in the ball pockets group,and the excellent charging rate of the bone cement in the Mesh bag group(84.21%)was higher than that in the ball pocket group(60.53%),and the leakage rate of bone cement in the mesh bag group(2.63%)was lower than that in the ball pocket group(21.05%),the differences were statistically significant(P<0.05).At 3 days and 6 months after surgery,the visual analogue scale(VAS)score,oswestry disability index(ODI)score and the Cobb angle of the injured vertebrae in the two groups were lower than those before surgery,the anterior edge of the injured vertebra was higher than that of before surgery(P<0.05).but there were no statistically significant differences between the two groups(P>0.05).The incidence of re-fracture(13.16%)in the mesh bag group was lower than that in the ball pocket group(34.21%),the difference was statistically significant(P<0.05).Conclusion:The unilateral pedicle approach BFMCs vertebroplasty can relieve the pain of osteoporotic thoracolumbar compression fractures patients,restore and maintain the height of injured vertebra,correct the deformity of injured vertebra,help to reduce the amount of bone cement injection,improve the excellent rate of bone cement filling,reduce the leakage rate of bone cement,and reduce the incidence of re-fracture.