经皮高黏度骨水泥椎体成形术治疗老年胸腰段椎体压缩性骨折疗效分析

Analysis of the therapeutic efficacy of percutaneous high-viscosity bone cement vertebroplasty for old patients with thoracolumbar vertebral compression fractures

目的探讨经皮椎体高黏度骨水泥成形术治疗老年骨质疏松性胸腰段压缩性骨折临床疗效。方法选取2021年1月至2022年2月安徽理工大学第一附属医院脊柱外科收治的31例老年性胸腰段压缩性骨折病人为研究对象,所有病人伤椎均为单一椎体新鲜骨折,伤椎采用经皮注入高黏度骨水泥。比较治疗前和治疗后各时间点病人疼痛视觉模拟评分法(VAS)评分、活动能力评分及Oswestry功能障碍指数(ODI);比较治疗前和治疗后各时间点伤椎后凸角和前后缘高度。结果31例伤椎骨水泥注入治疗后第2天、1个月、3个月、6个月、1年椎体前缘高度[(27.07±1.93)mm、(27.01±1.96)mm、(26.94±1.89)mm、(26.95±1.89)mm、(26.92±1.92)mm]均高于术前(18.62±2.02)mm(P<0.05),后凸角[(6.96±0.86)°、(6.94±0.86)°、(6.98±0.87)°、(6.95±0.87)°、(6.99±0.81)°]均低于术前(10.59±1.19)°(P<0.05);病人术后各时间点VAS评分、活动能力评分及ODI指数均低于术前(P<0.05)。结论老年骨质疏松性胸腰段椎体新鲜压缩性骨折采用经皮椎体高黏度骨水泥成形术治疗效果明显,能有效恢复伤椎高度、纠正后凸角,明显减轻病人疼痛、提高生活质量。

Objective To explore the clinical efficacy of high viscosity percutaneous vertebral bone cementoplasty for the treatment of osteoporotic thoracolumbar compression fractures in the elderly individuals.Methods A total of 31 elderly patients with thoraco-lumbar compression fractures admitted to the Department of Spine Surgery of the First Affiliated Hospital of Anhui University of Sci-ence and Technology from January 2021 to February 2022 were selected as research subjects.All patients'injured vertebrae were sin-gle vertebral body fresh fractures,and the injured vertebrae were injected percutaneously with high viscosity bone cement.The pa-tients'visual analog scale(VAS)pain scores,mobility scores,and Oswestry dysfunction index(ODI)scores were compared at each time point before and after treatment.The posterior convexity angle and height of the anterior and posterior margins of the injured vertebrae were compared at each time point before and after treatment.Results The height of the anterior margin of the vertebral body[(27.07±1.93)mm,(27.01±1.96)mm,(26.94±1.89)mm,(26.95±1.89)mm,(26.92±1.92)mm]was greater than that of the preoperative period in 31 cases of injured vertebral body cement injection treatment on the 2nd day,1 month,3 months,6 months,and 1 year(18.62±2.02)mm(P<0.05),and the posterior convexity angle[(6.96±0.86)°,(6.94±0.86)°,(6.98±0.87)°,(6.95±0.87)°,(6.99±0.81)°]was lower than that of the preoperative value(10.59±1.19)°(P<0.05).The patients'postoperative VAS scores,mobility scores,and ODI indices were lower than their preoperative scores at all time points(P<0.05).Conclusion Percutaneous vertebral high-viscosity cementoplasty for osteoporotic thoracolumbar vertebral compression fractures effectively restores the height of the injured vertebra,corrects the kyphosis angle,and significantly reduces patient pain and improves quality of life.