椎体成形骨水泥注射治疗骨质疏松性椎体压缩骨折的效果及其骨水泥情况分析

Effect and Bone Cement Situation of Percutaneous Vertebroplasty Bone Cement Injection in the Treatment of Osteoporotic Vertebral Compression Fractures

目的:探讨椎体成形(PVP)骨水泥注射治疗骨质疏松性椎体压缩骨折(OVCF)的效果及其骨水泥分布情况。方法:选择2017年1月-2022年1月盐城德馨医院收治的100例骨质疏松性椎体压缩骨折患者作为研究对象,采用随机数表法将其分为传统组与PVP组,各50例。PVP组采用PVP骨水泥注射治疗,传统组采用传统保守治疗。比较两组治疗前、治疗后3个月、1年的视觉模拟评分法(VAS)评分、腰椎Oswestry功能障碍指数(ODI)评分及患者伤椎椎体前缘高度;比较两组治疗后1年再骨折发生情况;观察PVP组骨水泥分布、渗漏情况。结果:治疗前,两组VAS评分与ODI评分比较,差异无统计学意义(P>0.05);治疗后3个月,两组VAS评分、ODI评分均低于治疗前,且PVP组低于传统组,差异有统计学意义(P<0.05);治疗后1年,两组VAS评分均低于治疗前及治疗后3个月,且PVP组VAS评分低于传统组,差异有统计学意义(P<0.05);治疗后1年,传统组ODI评分均低于治疗前及治疗后3个月,差异有统计学意义(P<0.05),而PVP组治疗后3个月与治疗后1年ODI评分比较,差异无统计学意义(P>0.05),两组治疗后1年ODI评分比较,差异无统计学意义(P>0.05)。治疗前,两组伤椎椎体前缘高度比较,差异无统计学意义(P>0.05);治疗后3个月、1年,两组伤椎椎体前缘高度均高于治疗前,且PVP组高于传统组,差异有统计学意义(P<0.05);治疗后1年,两组伤椎椎体前缘高度略低于治疗后3个月,但差异无统计学意义(P>0.05)。PVP组再骨折发生率为20.00%,低于传统组的26.00%,但两组间比较,差异无统计学意义(P>0.05)。PVP组中骨水泥单侧分布11例(22.00%),单侧充盈15例(30.00%),双侧分布20例(40.00%),双侧充盈4例(8.00%),发生骨水泥渗漏13例(26.00%)。结论:较于传统保守治疗OVCF,PVP骨水泥注射治疗起效更快、效果更佳;但PVP注射骨水泥骨水泥弥散程度、渗漏等仍需改善。

Objective:To explore the effectiveness and bone cement distribution status of percutaneous vertebroplasty(PVP)bone cement injection in the treatment of osteoporotic vertebral compression fractures(OVCF).Method:A total of 100 patients with OVCF admitted to Yancheng Dexin Hospital from January 2017 to January 2022 were selected as the study subjects.They were divided into traditional group and PVP group using random number table method,with 50 patients in each group.PVP group was treated with PVP bone cement injection,while the traditional group was treated with traditional conservative treatment.The visual analogue scale(VAS)scores,lumbar oswestry dysfunction index(ODI)scores,and the anterior edge height of the injured vertebral body between the two groups before treatment,3 months,and 1 year after treatment were compared.The incidence of recurrent fractures between the two groups 1 year after treatment were compared.Observed the distribution and leakage of bone cement in the PVP group.Result:Before treatment,there were no statistically significant differences in VAS scores and ODI scores between the two groups(P>0.05).At 3 months after treatment,the VAS scores and ODI scores of the two groups were lower than those before treatment,and the PVP group were lower than those in the traditional group,the differences were statistically significant(P<0.05).At 1 year after treatment,the VAS scores of both groups were lower than those before and 3 months after treatment,and the VAS scores of the PVP group was lower than that of the traditional group,the differences were statistically significant(P<0.05).At 1 year after treatment,the ODI scores of the traditional group was lower than those before and 3 months after treatment,the differences were statistically significant(P<0.05);however,there was no significant difference in ODI scores between the PVP group at 3 months and 1 year after treatment(P>0.05),and there was no significant difference in ODI scores between the two groups at 1 year after treatment(P>0.05).Before treatment,there was no statistically significant difference in the anterior edge height of the injured vertebral body between the two groups(P>0.05).At 3 months and 1 year after treatment,the anterior edge height of the injured vertebral body in both groups were higher than those before treatment,and the PVP group was higher than that in the traditional group,the differences were statistically significant(P<0.05).At 1 year after treatment,the anterior edge height of the injured vertebral body in the two groups was slightly lower than 3 months after treatment,but the differences were not statistically significant(P>0.05).The incidence of recurrent fractures in the PVP group was 20.00%,which was lower than 26.00%in the traditional group,but there was no statistically significant difference between the two groups(P>0.05).In the PVP group,there were 11 cases(22.00%)with unilateral distribution of bone cement,15 cases(30.00%)with unilateral filling,20 cases(40.00%)with bilateral distribution,4 cases(8.00%)with bilateral filling,and 13 cases(26.00%)with bone cement leakage.Conclusion:Compared with the traditional conservative treatment of OVCF,PVP bone cement injection treatment has faster onset and better effect.However,the dispersion and leakage of PVP injection bone cement still need to be improved.