摘要
背景:经皮椎体后凸成形已成为治疗骨质疏松性椎体压缩骨折的有效方法,但骨水泥在椎体内分的布情况可导致术后临床症状有一定的差异。目的:探讨经皮椎体后凸成形后骨水泥分布对不同部位椎体压缩骨折临床疗效的影响。方法:选择2017年1月至2019年1月大连大学附属中山医院收治的骨质疏松性椎体压缩骨折患者339例,年龄60-85岁,其中胸椎骨折组144例、腰椎骨折组195例,均进行经皮椎体后凸成形骨水泥注射治疗。术后根据骨水泥在椎体内的弥散分布情况将两组分为Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型、Ⅴ型。术前、术后3d及6个月进行目测类比评分与Oswestry功能障碍指数评定。研究获得大连大学附属中山医院医学伦理委员会批准。结果与结论:①两组术后3d、6个月的目测类比评分、Oswestry功能障碍指数评分均较术前明显下降(P<0.05),且术后6个月的目测类比评分、Oswestry功能障碍指数评分较术后3 d进一步下降(P<0.05);②术后6个月当骨水泥分布为相同类型时,两组间目测类比评分、Oswestry功能障碍指数评分比较差异均无显著性意义(P>0.05);③术后6个月胸椎骨折组内,不同分型间的Oswestry功能障碍指数评分比较差异无显著性意义(P>0.05),Ⅰ型、Ⅱ型、Ⅲ型的目测类比评分低于Ⅳ型、Ⅴ型(P<0.05);④术后6个月腰椎骨折组内,不同分型间的Oswestry功能障碍指数评分比较差异均无显著性意义(P>0.05),Ⅰ型、Ⅱ型、Ⅲ型的目测类比评分低于Ⅳ型、Ⅴ型(P<0.05);⑤结果表明,经皮椎体后凸成形后骨水泥在椎体内呈Ⅰ-Ⅲ型弥散分布可更好地缓解疼痛。
BACKGROUND: Percutaneous kyphoplasty(PKP) has become an effective method for the treatment of osteoporotic vertebral compression fractures, but the distribution of bone cement in the vertebral body can cause certain differences in postoperative clinical symptoms. OBJECTIVE: To investigate the clinical effect of bone cement distribution on the treatment of vertebral compression fractures in different sites after percutaneous kyphoplasty. METHODS: A retrospective analysis of eligible 339 patients with vertebral compression fractures at different sites who received treatment at the Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University from January 2017 to January 2019 were included in this study. These patients were aged 60-85 years. They were divided into a thoracic fracture group(n=144) and a lumbar fracture group(n=195). All patients received bone cement injection after percutaneous kyphoplasty. After surgery, the diffusion distribution of bone cement in the vertebral body was divided into I-V types in each group. Visual Analogue Scale score and Oswestry Disability Index were evaluated before surgery, and 3 days and 6 months after surgery. This study was approved by the Medical Ethics Committee, Affiliated Zhongshan Hospital of Dalian University, China. RESULTS AND CONCLUSION:(1) At 3 days and 6 months after surgery, Visual Analogue Scale score and Oswestry Disability Index were significantly decreased compared with before surgery(P < 0.05). Visual Analogue Scale score and Oswestry Disability Index at 6 months after surgery were significantly lower than those at 3 days after surgery(P < 0.05).(2) At 6 months after surgery, there were no significant differences in Visual Analogue Scale score and Oswestry Disability Index between thoracic fracture and lumbar fracture groups when the distribution type of bone cement was the same(P > 0.05).(3) At 6 months after surgery, there was no significant difference in Oswestry Disability Index between different distribution types of bone cement in the thoracic fracture group(P > 0.05). At 6 months after surgery, Visual Analogue Scale score in patients with types I, II and III bone cement distribution was significantly lower than in those with types Ⅳ and Ⅴ bone cement distribution(P < 0.05).(4) At 6 months after surgery, there was no significant difference in Oswestry Disability Index between different distribution types of bone cement in the lumbar fracture group(P > 0.05). At 6 months after surgery, Visual Analogue Scale score in patients with types Ⅰ, Ⅱ and Ⅲ bone cement distribution was significantly lower than in that in patients undergoing types Ⅳ and Ⅴ bone cement distribution(P < 0.05).(5) These results suggest that after percutaneous kyphoplasty, bone cement distributed in types Ⅰ-Ⅲ can lead to better pain relief than that distributed in other types.
作者
谢辉
陈浩鹏
王本杰
傅维民
赵德伟
Xie Hui;Chen Haopeng;Wang Benjie;Fu Weimin;Zhao Dewei(Department of Orthopedics,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,Liaoning Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第28期4505-4510,共6页
Chinese Journal of Tissue Engineering Research
基金
国家十三五“国家重点研发计划”项目(2016YFC1102000),项目负责人:赵德伟,项目名称:生物活性脊柱及节段骨缺损修复器械的产品研发。
