经皮椎体后凸成形术治疗有腰椎融合术史的骨质疏松性椎体压缩性骨折的临床效果

Clinical efficacy of percutaneous kyphoplasty on osteoporotic vertebral compression fracture with a history of lumbar fusion surgery

目的探讨经皮椎体后凸成形术治疗有腰椎融合术史的骨质疏松性椎体压缩性骨折(OVCF)的临床效果。方法回顾性分析2018年3月至2022年7月江阴市人民医院收治的因OVCF入院,并行经皮椎体后凸成形术(PKP)治疗的患者,随访3个月以上。其中既往有腰椎融合术史患者16例(融合组),无腰椎融合术史患者45例(对照组)。比较两组年龄、骨密度、伤椎分布规律、手术时间、骨水泥用量,比较两组术前、术后2 d、术后3个月腰痛视觉模拟评分(VAS)、椎体高度以及骨水泥渗漏情况。结果融合组和对照组患者的手术时间、骨水泥用量及骨水泥渗漏情况比较,差异无统计学意义(P>0.05)。融合组骨密度高于对照组,差异有统计学意义(P<0.05)。融合组平均年龄小于对照组,差异有统计学意义(P<0.05)。两组患者术后2 d、术后3个月的VAS评分均低于术前,椎体高度均高于术前,差异有统计学意义(P<0.05)。两组术后3个月VAS评分比较,差异无统计学意义(P>0.05)。结论腰椎融合术后的患者发生OVCF的年龄更早,PKP对于有腰椎融合术史的OVCF患者安全、有效。

Objective To investigate the clinical efficacy of percutaneous kyphoplasty(PKP)on osteoporotic vertebral compression fracture(OVCF)with a history of lumbar fusion surgery.Methods Patients admitted to Jiangyin People’s Hospital for OVCF and treated with PKP from March 2018 to July 2022 were retrospectively analyzed,and they were followed up for more than 3 months.The patients were divided into the fusion group(n=16,Group A,with a previous history of lumbar fusion surgery)and the control group(n=45,Group B,without a history of lumbar fusion surgery).The ages,bone mineral densities,distribution patterns of injured vertebrae,operation time,dosages of bone cement,visual analogue scale(VAS)of low back pain before operation,2 days after operation and 3 months after operation,vertebral heights and bone cement leakages were compared between the two groups.Results There were no statistically significant differences in operation time,dosages of bone cement and bone cement leakages between the fusion group and the control group(P>0.05).Bone mineral density in the fusion group was higher than that in the control group,with statistically significant difference(P<0.05).The age of the fusion group was younger than that of the control group,with statistically significant difference(P<0.05).2 days and 3 months after operation,the VAS scores of two groups of patients were all lower than those before operation,and the height of diseased vertebrae were all higher than those before operation,with statistically significant differences(P<0.05).3 months after operation,there was no statistically significant difference in VAS score between the two groups(P>0.05).Conclusion The patients after lumbar fusion surgery have OVCF at an earlier age,and PKP is safe and effective for OVCF patie nts with a history of lumbar fusion surgery.