腰椎定量QCT对骨质疏松性胸腰椎骨折行椎体成形术的指导价值评价

Guiding Value Evaluation of Lumbar Quantitative QCT for Osteoporotic Thoracolumbar Fracture

目的评价腰椎定量CT(QCT)对骨质疏松性胸腰椎骨折(OVCF)行椎体成形术(PVP)的指导价值。方法以2022年4月—2023年7月本院收治的80例OVCF患者为研究对象,回顾分析80例患者的常规资料,并根据腰椎QCT值对患者实施分组。其中,QCT值80~120g/L属低骨量组、QCT值40~80g/L属骨质疏松组、QCT值<40g/L属重度骨质疏松组。术中通过X线对骨水泥渗漏、弥散状况进行观察,弥散超出椎体中线的患者实施单侧入路,反之实施双侧入路。结果①80例患者中,65例骨水泥弥散超出了椎体中线,占比80.61%。3组骨水泥弥散情况出现显著差异,有统计学意义(P<0.05)。3组骨水泥渗漏情况未出现显著差异(P>0.05)。②3组在PVP术式选择上存有显著差异,有统计学意义(P<0.05)。结论基于腰椎QCT指导展开PVP治疗,能够降低透视次数,提升PVP安全性。

Objective To evaluate guiding value of lumbar quantitative CT(QCT)for vertebroplasty(PVP)of osteoporotic thoracolumbar fractures(OVCF).Methods The paper chose 80 OVCF patients admitted to our hospital from April 2022 to July 2023 as study subjects.reviewed and analyzed their routine data,and divided them into groups according to lumbar QCT values.Cases with QCT values of 80-120g/L were included in low bone mass group,those with QCT values of 40-80g/L in osteoporosis group,and those with QCT values<40g/L in severe osteoporosis group.During the operation,leakage and diffusion of bone cement was observed with X-ray.Patients with diffusion beyond midline of vertebral body were treated with unilateral approach,while patients with diffusion beyond midline of the vertebral body with bilateral approach.Results①Among the 80 cases,65 cases had bone cement diffusion beyond midline of the vertebral body,accounting for 80.61%,there was significant difference in dispersion of bone cement among three groups,with(P<0.05).There was no significant difference in leakage of bone cement among three groups(P>0.05).②There was significant difference in selection of PVP surgery among three groups,(P<0.05).Conclusion PVP treatment guided by lumbar QCT can reduce frequency of fluoroscopy and improve the safety of PVP.