双侧不同骨水泥注入量PVP手术对骨质疏松性胸腰椎压缩骨折的治疗效果影响对比

摘要

Objective To compare the clinical effect of different bone cement infusion on osteoporotic thoracolumbar vertebral compression fractures(OVCF)in percutaneous vertebroplasty(PVP) surgery. Methods The patients with OVCF in our hospital from December 2015 to December 2016 were treated with bilateral PVP.The visual analogue scale(VAS),the Japanese Orthopedic Association (JOA) score, the recovery of the vertebral height, the incidence of bone cement leakage and so on, the oswestry dysfunction index (ODI) were observed and analyzed. Results The operation time, intraoperative radiation time and bone cement leakage rate in the bilateral large amount bone cement injection group were significantly higher than those in the bilateral bone small amount cement injection group(P<0.05).After treatment,the VAS,Cobb angle,ODI,JOA and vertebral height of the two groups were significantly improved, the differences were statistically significant (P<0.05). The VAS, Cobb angle, ODI, JOA and vertebrae height between the two groups had no significant difference (P>0.05). Conclusion Bilateral large amount bone cement injection can significantly increase the leakage rate of bone cement, in the future operation of traditional Chinese medicine practitioners should accurately calculate the amount of bone cement injection to reduce bone leakage rate.%目的 比较PVP手术中不同骨水泥注入量对骨质疏松性胸腰椎压缩骨折(OVCF)的临床治疗效果.方法 回顾性分析2015-12月-2016-12期间在我院收治的骨质疏松性胸腰椎压缩骨折行双侧经皮椎体成形术(PVP)治疗的病例,观察视觉疼痛模拟评分(visual analogue scale,VAS评分)、后凸畸形角(Cobb角)的测量、oswestry功能不良指数(ODI)、日本骨科协会评估治疗分数(JOA)、恢复的椎体高度、骨水泥渗漏发生率等并进行统计学分析.结果 双侧多量骨水泥注入量组的手术时间、术中放射辐射时间以及骨水泥渗漏率较双侧少量骨水泥注入量组显著升高,差异有统计学意义(P<0.05);治疗后两组患者的VAS、Cobb角、ODI、JOA和椎体高度均有显著性改善,差异具有统计学意义(P<0.05);术后两组患者间的VAS、Cobb角、ODI、JOA和椎体高度无明显差异(P>0.05).结论 双侧均采取多量注入可以明显增加骨水泥的渗漏率,在今后的手术中医者应该精确计算骨水泥注入量,以减少骨水泥渗漏率.