远程遥控骨水泥自动推注系统辅助下PVP治疗老年骨质疏松性胸腰椎压缩骨折

The clinical effect of percutaneous vertebroplasty in treatment of osteoporotic vertebral compression fractures with assistance of remote-controlled injection manipulator system

目的评价远程遥控骨水泥自动推注系统辅助下PVP治疗老年骨质疏松性胸腰椎压缩骨折的临床疗效。方法分析2019年9月~2020年3月接受该手术的35例患者,术前、术后当天和术后3个月采用简式McGill疼痛问卷进行疼痛评价;通过手术时长、X线暴露时间、骨水泥推注剂量、骨水泥渗漏率等指标,衡量该术式的优势。结果患者术后当天和术后3个月时,McGill疼痛问卷的选词阳性项目数、PRI、VAS和PPI均比术前显著降低(P<0.01);与术后当天相比,术后3个月的上述指标仍有进一步改善(P<0.01)。所有病例均无脊髓神经损伤、肺栓塞和骨水泥渗漏等并发症。结论PVP是治疗OVCF安全有效的微创方式,配合远程遥控骨水泥自动推注系统可使骨水泥匀速缓慢推注,有效防止渗漏,减少射线暴露,术者可得到最大限度的辐射防护,同时节省手术时间,值得临床应用。

Objective To evaluate the clinical effect of percutaneous vertebroplasty(PVP)in treatment of senile thoracic and lumbar osteoporotic vertebral compression fracture(OVCF)with the assistance of a remote-controlled bone cement injection manipulator system.Methods The clinical data were analyzed in 35 elderly patients with osteoporotic thoracic and lumbar vertebral compression fractures who received the treatment of this surgical method from September 2019 to March 2020.These patients were asked to finish the short-form McGill Pain Questionnaires(SF-MPQ)to assess the effect before the operation,after surgery and three months after surgery,respectively.The results of the questionnaires were used to compare pain levels of the patients between their pre-surgical and post-surgical stages.The benefits of this method of surgery was also measured by the operation time duration,the radiation dose duration,the dose of bone cement injection and the leakage rate of bone cement.Results The pain rating index(PRI)score,the visual analogue scale(VAS)score and the present pain intensity(PPI)score of postoperative and of 3-month-postoperative stages were all significantly lower than those of before surgery stage(P<0.01).The clinical indicators of these patients three months after surgery were significantly different fromthose after surgery(P<0.01).All cases were free of complications such as spinal nerve damage,pulmonary embolism and bone cement leakage.Conclusion The PVP with the assistance of remote-controlled bone cement injection manipulator system can achieve the slow and constant injection of bone cement into the compressed vertebra,which can effectively prevent the leakage of bone cement and significantly reduce the exposure duration under X-ray.The surgeons can also get the maximum radiation protection and save the operation time,so it is worth clinical application.