摘要
目的探讨矿化胶原改性骨水泥在骨质疏松性椎体压缩骨折经皮椎体成形术中的应用。方法前瞻性研究2017年9月—2019年9月华中科技大学同济医学院附属梨园医院收治骨质疏松性椎体压缩骨折患者123例,男性70例,女性53例;年龄44~75岁,平均54.3岁。提物受伤63例,摔伤60例。按术中使用的骨水泥不同分为观察组(65例)和对照组(58例)。观察组采用矿化胶原改性骨水泥治疗,对照组给予传统骨水泥治疗。比较两组患者手术进行情况指标、伤椎(前缘、中部、后缘)高度、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、并发症(骨水泥渗漏、邻椎骨折、切口感染、松动移位)发生率。结果两组患者手术时间、术中出血量、住院时间比较差异无统计学意义。术后2d两组患者椎体前缘、中部、后缘高度均显著改善,但差异无统计学意义。两组患者术后3个月VAS与术前比较[(6.7±1.9)分vs.(1.6±0.6)分、(6.5±1.8)分vs.(1.9±0.6)分]均降低,术后3个月ODI[(33.1±8.0)分vs.(19.4±5.1)分、(32.5±7.9)分vs.(22.1±5.1)分]均降低,且观察组VAS、ODI均低于对照组[(1.6±0.6)分vs.(1.9±0.6)分、(19.4±5.1)分vs.(22.1±5.1)分,P<0.05]。观察组并发症发生率8%(5/65)低于对照组21%(12/58),组间比较差异有统计学意义(P<0.05)。结论矿化胶原改性骨水泥在骨质疏松性椎体压缩骨折经皮椎体成形术中应用效果良好,能改善患者的疼痛程度、功能障碍评分,且能降低骨水泥的相关并发症,值得临床推荐。
Objective To investigate the application of mineralized collagen modified bone cement in percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Methods A prospective study was conducted. From Sep. 2017 to Sep. 2019,123 patients with osteoporotic vertebral compression fractures were treated in Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology. There were 70 males and 53 females,with an average age of 54.3 years (44-75 years). Sixty-three cases were injured by doing weights and 60 cases were injured by falls. According to the different bone cements used in the operation,they were divided into observation group (65 cases) and control group (58 cases). The observation group was treated with mineralized collagen modified bone cement,and the control group was treated with traditional bone cement.The operation performance indicators,the height of the injured vertebrae (anterior,middle,and posterior),visual analog scale (VAS),Oswestry dysfunction index (ODI),complications (bone cement leakage,adjacent vertebral fractures,incisions) and the incidence of infection,loosening and displacement) were compared between the two groups. Results There was no significant difference in operation time,intraoperative blood loss,and hospitalization time between the two groups ( P =0.258,0.254,0.258). The heights of the anterior,middle,and posterior edges of the vertebral body of the two groups were significantly improved,but the difference was not statistically significant ( P =0.370, 0.344 ,0.550). The VAS[(6.7±1.9) points vs. (1.6±0.6) points and (6.5±1.8) points vs. (1.9±0.6) points] of the two groups of patients were reduced at 3 months after operation. The ODI [(33.1±8.0) points vs. (19.4± 5.1 ) points,(32.5±7.9) points vs. (22.1±5.1) points] all decreased,and the observation group's VAS and ODI were lower than those of the control group [(1.6±0.6) points vs. (1.9±0.6) points,(19.4±5.1) points vs. ( 22.1 ±5.1) points, P <0.05]. The incidence of complications in the observation group was 8% (5/65),which was lower than 21% (12/58) in the control group. The difference between the two groups was statistically significant( P < 0.05 ). Conclusion The application effect of mineralized collagen modified bone cement in percutaneous vertebroplasty for osteoporotic vertebral compression fractures is good,which can improve the pain degree and dysfunction score of patients,and reduce the complications related to bone cement,which is worthy of clinical recommendation.
作者
黄松
陈敬有
魏优秀
周伟
Huang Song;Chen Jingyou;Wei Youxiu;Zhou Wei(Department of Orthopedics,Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000,China)
出处
《创伤外科杂志》
2021年第5期350-354,共5页
Journal of Traumatic Surgery
基金
湖北省卫生和计划生育委员会科研项目(WJ2017MB109)。
关键词
椎体压缩骨折
骨水泥
矿化胶原
渗漏
骨质疏松
vertebral compression fracture
bone cement
mineralized collagen
leakage
osteoporosis
