OVCF患者PKP治疗中Genant分级与穿刺侧选择的匹配获益及预后分析

Analysis of matching benefit and prognosis of Genant grade and puncture side selection in PKP treatment in OVCF patients

目的:探讨骨质疏松性椎体压缩骨折(OVCF)患者经皮椎体后凸成形术(PKP)治疗中Genant分级与穿刺侧选择对治疗效果的影响。方法:选取2019年1月至2020年12月在我院就诊的OVCF患者145例,其中双侧穿刺患者75例,单侧穿刺患者70例;Genant半定量分级:Ⅰ级105例,Ⅱ级31例,Ⅲ级9例;观察双侧穿刺和单侧穿刺患者手术时间、术中出血量、Cobb角、椎体前缘高度等指标。结果:单侧穿刺组手术时间、术中出血量、术中透视次数和骨水泥注入量分别为(42.23±6.15)min、(7.50±1.00)ml、(24.50±2.29)次和(5.10±0.97)ml,明显少于双侧穿刺组(P<0.05);单侧穿刺和双侧穿刺组手术前后VAS评分比较差异无统计学意义(P>0.05);在Genant分级Ⅰ级患者中,单侧穿刺和双侧穿刺组手术前后Cobb角、椎体前缘高度、ODI指数比较差异无统计学意义(P>0.05);在Genant分级Ⅱ~Ⅲ级患者中,双侧穿刺组术后1个月、12个月Cobb角、ODI指数明显低于单侧穿刺组(P<0.05),椎体前缘高度明显高于单侧穿刺组(P<0.05)。结论:在PKP治疗OVCF患者中,对于Genant分级Ⅰ级患者可应用单侧穿刺入路治疗,而Ⅱ~Ⅲ级患者建议应用双侧穿刺入路治疗。

Objective To investigate the effect of Genant grade and puncture side selection on the treatment effect of percutaneous vertebral kyphoplasty(PKP)treatment in patients with osteoporotic vertebral compression fracture(OVCF).Methods A total of 145 OVCF patients visited our hospital from January 2019 to December 2020,including 75 bilateral puncture patients and 70 unilateral puncture patients;Genant semi-quantitative classification:105 grade I 1,31 grade 9 patients;and operation time,intraoperative bleeding volume,Cobb angle,and anterior edge height of vertebral body of bilateral puncture and unilateral puncture patients.Results Operation time,intraoperative bleeding,intraoperative fluoroscopy,and cement injection were(42.23±6.15)min,(7.50±1.00)ml,(24.50±2.29)and(5.10±0.97)ml,respectively,Significantly less than that in the bilateral puncture group(P<0.05);There was no significant difference between the VAS scores before and after the unilateral puncture and bilateral puncture groups(P>0.05);In patients with Genant grade I,There was no significant difference in Cobb angle,vertebral leading edge height,and ODI index before and after unilateral and bilateral puncture group(P>0.05);In patients with Genant grade~The Cobb angle and ODI index at 1 month and 12 months were significantly lower than those in the unilateral puncture group(P<0.05),The height of the vertebral front was significantly higher than that in the unilateral puncture group(P<0.05).Conclusion In OVCF patients with PKP,unilateral puncture approach can be applied for patients with Genant grade I,while bilateral puncture approach is recommended for~grade patients.