CT引导骨填充网袋成形术治疗老年骨质疏松性椎体压缩骨折的疗效

Effect of CT-guided bone filling mesh bag plasty on elderly osteoporotic vertebral compression fracture

目的 探讨CT引导骨填充网袋成形术治疗老年骨质疏松性椎体压缩骨折(OVCF)的疗效。方法 采用CT引导骨填充网袋成形术治疗29例老年OVCF患者(33椎)。记录手术时间、骨水泥注入量、骨水泥渗漏情况、术后并发症发生情况。比较手术前后疼痛VAS评分、Cobb角、ODI、伤椎前缘高度比。结果 患者均获得随访,时间12~15个月。手术时间38~54 min/椎,骨水泥注入量:胸椎2~2.5 ml/椎,腰椎3~4 ml/椎。围手术期均未发生死亡、穿刺针孔感染等情况;2例骨水泥向椎体前方少量渗漏,但无临床症状。伤椎前缘高度比、疼痛VAS评分、Cobb角、ODI:术后3 d及末次随访均较术前明显改善(P<0.05),末次随访与术后3 d比较差异均无统计学意义(P>0.05)。末次随访时,患者正常负重行走时下肢肌力正常,未出现脊髓神经压迫症状。结论 CT引导骨填充网袋成形术治疗OVCF,具有提高手术操作精准度、提高椎体稳定性、有效避免骨水泥渗漏的优势。

Objective To investigate the efficacy of CT-guided bone filling mesh bag plasty in the treatment of elderly osteoporotic vertebral compression fracture(OVCF).Methods The 29 elderly patients(33 vertebrae)with OVCFs were treated with CT-guided bone filling mesh bag plasty.The operation time,bone cement injection volume,bone cement leakage and postoperative complications were recorded.Pain VAS,Cobb angle,ODI,and anterior edge height ratio of injured vertebrae were compared before and after surgery.Results All patients were followed up for 12~15 months.The operation time was 38~54 min per vertebra.The volume of bone cement injected was 2~2.5 ml per vertebra for thoracic vertebra,and 3~4 ml per vertebra for lumbar vertebra.During the perioperative period,no death or puncture needle hole infection occurred;and 2 cases had less volume of bone cement leakage to front of the vertebrae,but there was no clinical symptoms.The anterior edge height ratio of injured vertebrae,pain VAS,Cobb angle and ODI:at 3 d after operation and the last follow-up,they were significantly improved than the preoperation(P<0.05),but there were no significant differences between the last follow-up and 3 d postoperation(P>0.05).At last follow-up,the lower extremity muscle strength was normal when the patients walked with normal weight-bearing,and no symptoms of spinal nerve compression were observed.Conclusions In the treatment of OVCF,CT-guided bone filling mesh bag plasty has the advantages of significantly improving the surgical accuracy,and the stability of the vertebrae,and effectively avoiding bone cement leakage.