骨质疏松性胸腰椎骨折经皮椎体成形术后骨水泥分布类型对疗效的影响

Effect of bone cement distribution on curative effect after percutaneous vertebroplasty for osteoporotic thoracolumbar fractures

目的探究骨质疏松性胸腰椎骨折经皮椎体成形术(PVP)后骨水泥分布类型对疗效的影响。方法选取中国人民解放军东部战区总医院淮安医疗区2018年1月至2020年12月收治的83例行PVP术的骨质疏松性胸腰椎骨折患者作为研究对象,术后72 h复查CT检测骨水泥分布形态,将其分为骨水泥弥散组和骨水泥非弥散组,其中骨水泥非弥散组42例,骨水泥弥散组41例。比较两组手术前后疼痛程度、椎体功能、椎体校正情况及并发症。结果术后两组视觉模拟评分法评分、腰椎功能障碍指数评分较术前均降低,且骨水泥弥散组均低于骨水泥非弥散组(P<0.05)。术后两组伤椎中线相对高度及伤椎前缘相对高度均高于术前,伤椎局部后Cobb角均低于术前(P<0.05)。两组术后骨水泥渗漏率比较,差异无统计学意义(P>0.05)。结论骨质疏松性胸腰椎骨折患者PVP术后,骨水泥弥散分布较骨水泥非弥散分布更利于降低患者术后疼痛程度,提升椎体相关运动功能,临床疗效较佳。

Objective To explore the effect of bone cement distribution on the curative effect of percutaneous vertebroplasty(PVP)for osteoporotic thoracolumbar fractures.Methods A total of 83 patients with osteoporotic thoracolumbar fractures treated by PVP in Huaian Medical District of the Eastern Theater General Hospital of the Chinese People’s Liberation Army from January 2018 to December 2020 were selected as the research object,CT was rechecked 72 hours after operation to detect the distribution of bone cement,they were divided into bone cement diffusion group and bone cement non diffusion group,including 42 cases in bone cement non diffusion group and 41 cases in bone cement diffusion group.The degree of pain,vertebral body function,vertebral body correction and complications before and after operation were compared between the two groups.Results Visual analog scale score and lumbar dysfunction index score were lower in both groups after surgery than before surgery,and the bone cement diffusion group was lower than the bone cement non-diffusion group(P<0.05).The relative height of the injured vertebral midline and the relative height of the injured vertebral front were higher than those before surgery,and the Cobb angle after local injured vertebral was lower than that before surgery(P<0.05).There was no significant difference in the postoperative bone cement leakage rate between the two groups(P>0.05).Conclusion In patients with osteoporotic thoracolumbar fractures,the dispersion distribution of bone cement after PVP is more conducive to reduce the degree of postoperative pain and improve the related motor function of vertebral body than the non dispersion distribution of bone cement,the clinical effect is better.