椎体成形术治疗合并椎体内裂隙样变骨质疏松压缩骨折疗效的观察

摘要

目的 观察椎体成形术对治疗合并椎体内裂隙样变骨质疏松(0P)压缩骨折疗效.方法 33例患者分A、B两组,14例合并裂隙样变(积气或积液)的OVCF患者为A组;19例无裂隙样变的为B组,术前常规行X线、患椎CT、MRI检查,双侧穿刺行PVP,比较两组间术前疼痛,分析两组骨水泥注入量;术后1天、1周、1月局部疼痛缓解;观察两组后凸畸形纠正和骨水泥渗漏情况.结果 两组间骨水泥注射量差异无统计学意义(P>0.05).两组术前VAS值无统计学意义(P>0.05);除术后1 d外,A组VAS值与同期B组相比,A组疼痛缓解较B组差,有统计学意义(P<0.05).两组后凸畸形矫正角度例数分布无统计学差异(P>0.05).两组间骨水泥外漏率差异无统计学意义(P>0.05).两组间骨水泥外漏类型分布差异有统计学意义(P<0.05).结论 合并与否IVC对PVP的疗效有一定影响;PVP纠正后凸畸形对合并与否IVC并无关系;后凸畸形的纠正度数并不能作为术后功能恢复的良好与否的判断标准;椎体内裂隙样变的存在与否对骨水泥外漏的类型有影响.%Objective To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) on vertebral body osteoporotic compression fractures combined with Intravertebral clefts (IVC).Methods Thirty-three patients were divided into two groups.Group A included 14 OVCF patients combined with IVC.Group B included 19 patients without IVC.X-ray, CT, and MRI examination of suffered vertebral bodies were routinely performed preoperatively.Bipedicular puncture PVP was performed.The level of preoperational pain and the cement dosage were compared between the two groups.The local pain was released after 1 day, 1 week, and 1 month after the operation.The correction of kyphosis deformity and bone cement leakage were observed.Results The bone cement injection dosage was not statistically significant between group A and group B ( P ＞ 0.05 ).Preoperative VAS value of both groups were not statistically significant ( P ＞ 0.05 ).Except for day 1 after the operation, VAS value in group A was worse than that in group B postoperatively with statistical significance ( P ＜ 0.05 ).The correction degree of kyphosis deformity was not statistically significant between group A and group B ( P ＞ 0.05 ).Bone cement leakage rate between the two groups was not statistically significant ( P ＞ 0.05 ).Bone cement leakage type distribution difference between two groups was statistically significant ( P ＜ 0.05 ).Conclusion Fracture patients combined with IVC had certain effects on the clinical efficacy of PVP.The correction of kyphosis deformity by PVP had no correlation with patients with IVC.The correction degree of kyphosis deformity was not the criteria of postoperative recovery of function.The existence of IVC influenced the bone cement leakage type.